scholarly journals Intravenous Oxycodone versus Intravenous Morphine in Cancer Pain: A Randomized, Open-Label, Parallel-Group, Active-Control Study

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Kyung-Hee Lee ◽  
Jung-Hun Kang ◽  
Ho-Suk Oh ◽  
Moon-Ki Choi ◽  
Byoung-Yong Shim ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Adverse Events ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Efficacy And Safety ◽  
Open Label ◽  
Patients With Cancer ◽  
Average Pain Intensity ◽  
Average Pain

Objective. To compare efficacy and safety of intravenous continuous infusion of oxycodone with morphine in patients with cancer pain.Methods. A 5-day, randomized, open-label, exploratory study at 6 sites in the Republic of Korea. Sixty-six adults aged ≥19 years with moderate-to-severe cancer pain (Numeric Rating Scale [NRS] ≥ 4) were enrolled. The study group received intravenous (IV) oxycodone, and the comparator group received IV morphine which were titrated depending on pain intensity. The efficacy endpoint is change in average NRS score from baseline to Day 5. Other assessments included worst, current, and average pain intensity; patient satisfaction; medication dose; and adverse events.Results. Both groups achieved >50% reduction in average pain intensity: from “moderate” at baseline (oxycodone versus morphine: 6.0 ± 1.8 versus 5.9 ± 1.4) to “mild” at Day 5 (2.5 ± 1.8 versus 2.8 ± 1.6). While this reduction was similar between groups (3.5 ± 2.2 versus 3.1 ± 1.8,Pvalue = 0.562), oxycodone achieved faster pain relief (average pain: 3.0 ± 1.6 versus 3.9 ± 1.6,Pvalue = 0.020) on Day 2 and significant NRS reductions for worst pain on Day 2 (Pvalue = 0.045) and current pain on Day 2 (Pvalue = 0.035) and Day 5 (Pvalue = 0.020) compared to morphine. Patient satisfaction, adverse events, and adverse drug reactions were similar for both groups.Conclusions. For Asian patients with cancer pain, IV oxycodone is faster acting and showed similar analgesic efficacy and safety profiles as IV morphine. This trial is registered with Clinicaltrials.govNCT02660229.

Efficacy of Methylprednisolone on Pain, Fatigue, and Appetite Loss in Patients With Advanced Cancer Using Opioids: A Randomized, Placebo-Controlled, Double-Blind Trial

2014 ◽  
Vol 32 (29) ◽  
pp. 3221-3228 ◽  
Author(s):  
Ørnulf Paulsen ◽  
Pål Klepstad ◽  
Jan Henrik Rosland ◽  
Nina Aass ◽  
Eva Albert ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Intensity ◽  
Rating Scale ◽  
Oral Morphine ◽  
Life Questionnaire ◽  
Appetite Loss ◽  
Patients With Cancer ◽  
Analgesic Consumption ◽  
Average Pain Intensity ◽  
Average Pain

Purpose Corticosteroids are frequently used in cancer pain management despite limited evidence. This study compares the analgesic efficacy of corticosteroid therapy with placebo. Patients and Methods Adult patients with cancer receiving opioids with average pain intensity ≥ 4 (numeric rating scale [NRS], 0 to 10) in the last 24 hours were eligible. Patients were randomly assigned to methylprednisolone (MP) 16 mg twice daily or placebo (PL) for 7 days. Primary outcome was average pain intensity measured at day 7 (NRS, 0 to 10); secondary outcomes were analgesic consumption (oral morphine equivalents), fatigue and appetite loss (European Organisation for Research and Treatment of Cancer–Quality of Life Questionnaire C30, 0 to 100), and patient satisfaction (NRS, 0 to 10). Results A total of 592 patients were screened; 50 were randomly assigned, and 47 were analyzed. Baseline opioid level was 269.9 mg in the MP arm and 160.4 mg in the PL arm. At day-7 evaluation, there was no difference between the groups in pain intensity (MP, 3.60 v PL, 3.68; P = .88) or relative analgesic consumption (MP, 1.19 v PL, 1.20; P = .95). Clinically and statistically significant improvements were found in fatigue (−17 v 3 points; P .003), appetite loss (−24 v 2 points; P = .003), and patient satisfaction (5.4 v 2.0 points; P = .001) in favor of the MP compared with the PL group, respectively. There were no differences in adverse effects between the groups. Conclusion MP 32 mg daily did not provide additional analgesia in patients with cancer receiving opioids, but it improved fatigue, appetite loss, and patient satisfaction. Clinical benefit beyond a short-term effect must be examined in a future study.

Targin - efficacy and safety of therapy following conversion from earlier opioid in patients with cancer pain. Observational study report

Ból ◽  
2016 ◽  
Vol 17 (3) ◽  
pp. 11-18
Author(s):  
Elwira Góraj
Keyword(s):  
Observational Study ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Analgesic Efficacy ◽  
Previous Treatment ◽  
Tolerability Profile ◽  
Efficacy And Safety ◽  
Average Pain Intensity ◽  
Average Pain ◽  
Strong Opioids

The aim of the study was evaluation of the efficacy, safety and compliance of the treatment with combination of oxycodone / naloxone (Targin) after the rotation from weak or strong opioid in a multicenter, open, prospective, observational study. Research group consisted of adult patients with chronic, severe cancer pain with presents of symptoms of Opioid Induced Constipation (OIC) associated with the previous treatment were enrolled into the rotation to oxycodone /naloxone (Targin). The study consisted of 4 visits in total, the observation was scheduled for 3 months. The following data were collected: daily dose of oxycodone / naloxone, pain intensity (NRS), adverse effects, number of omitted doses (compliance). After completion of all four visits an assessment of the efficacy and safety of the Targin treatment was made. A reduction in pain intensity (NRS) from baseline of 5.2 (average pain intensity at V1) to 2.1 (average pain intensity for V4) was observed. In sub-groups selected according to previous pain therapy, a reduction in pain intensity out of 5,0 (average pain intensity for V1 in patients treated earlier with strong opioids) to 2.1 (V4) and 5.7 (average pain intensity for V1 in patients treated earlier with weak opioids) to 2.1 (V4). The proportion of patients who did not require laxatives decreased from visit to visit. Patients who received Targin monotherapy after the rotation showed a greater compliance than patients who, in addition to Targin, also were prescribed with another opioid. In the group of patients who completed all four visits, efficacy was assessed as very good or good in 91.7% cases, similarly in 95.8% cases tolerability was evaluated as very good or good. Concluding, rotation to Targin from both, the weak and strong opioids, resulted in a very good and good pain control with reduction in the frequency and severity of OIC. The final result could be multifactorial, but we can confirm the good analgesic efficacy and favorable tolerability profile of Targin with significant reduction of OIC symptoms.

scholarly journals Progressive Response to Repeat Application of Capsaicin 179 mg (8% w/w) Cutaneous Patch in Peripheral Neuropathic Pain: Comprehensive New Analysis and Clinical Implications

Pain Medicine ◽  
2021 ◽  
Author(s):  
Rainer Freynhagen ◽  
Charles Argoff ◽  
Mariëlle Eerdekens ◽  
Sylvia Engelen ◽  
Serge Perrot
Keyword(s):  
Neuropathic Pain ◽  
Pain Intensity ◽  
Brief Pain Inventory ◽  
Initial Response ◽  
Open Label ◽  
Self Assessment ◽  
Peripheral Neuropathic Pain ◽  
Average Pain Intensity ◽  
Average Pain ◽  
Global Impression Of Change

Abstract Objective To investigate efficacy of repeated application of capsaicin 179 mg cutaneous patch in non-responders to the first application. Design Post hoc, as-treated analysis of two prospective trials (STRIDE and PACE) with 52-week follow-up. Blinding Open-label. Setting Multicenter clinical trial. Subjects STRIDE: non-diabetic neuropathic pain; PACE: painful diabetic peripheral neuropathy. Methods Patients were divided according to number of applications needed before ≥30% response on average pain intensity (question 5 of the Brief Pain Inventory [BPI-Q5]). We assessed change from baseline in average pain intensity (BPI-Q5), mean ‘interference with sleep’ score, Patient Global Impression of Change, quality of life (QOL) using EuroQol 5-dimension, and Self-Assessment of Treatment. Results In STRIDE and PACE, respectively, n = 306/313 received capsaicin patch; n = 60/96 had a response after the first application, n = 33/68 after the second, n = 11/43 after the third. Among patients without a ≥ 30% reduction in pain intensity at 3 months, 23.3%/28.1% achieved a ≥ 30% reduction at 6 months, increasing to 33.9%/45.7% at 12 months. Similar results were obtained using a decrease of ≥ 50% as responder definition. Progressive improvements in pain intensity in slower responders reached similar levels as those in early responders at month 12 and were accompanied by improvements in sleep, QOL, and patient satisfaction. Conclusions While some patients with peripheral neuropathic pain experience rapid improvements with a single treatment of capsaicin 179 mg patch, some may require two or three treatments before an initial response is observed. Similar benefits on pain, sleep, and QOL can be achieved in early and late responders.

scholarly journals The Effect of Celery Therapy and Abdominal Stretching Exercise on Pain Intensity in Adolescent with Dysmenorrhea at the Soppeng High School

2020 ◽  
Vol 8 (T2) ◽  
pp. 55-58
Author(s):  
Sri Rezkiani Kas ◽  
Nur Nasry Noor ◽  
Muh Tahir Abdullla ◽  
Anwar Mallongi ◽  
Erniwati Ibrahim
Keyword(s):  
High School ◽  
Reproductive Health ◽  
Pain Intensity ◽  
Rating Scale ◽  
Wilcoxon Test ◽  
Therapeutic Interventions ◽  
P Value ◽  
Average Pain Intensity ◽  
Before And After ◽  
Average Pain

BACKGROUND: Reproductive health is an important issue and needs to get more attention, especially among adolescents because adolescents are the nation’s next generation so adolescents should have excellent reproductive health because adolescents will later marry and become parents, so the quality of life of adolescents must improve to better direction. AIM: This study aimed to determine the effect of celery therapy and abdominal stretching exercise on pain intensity in adolescents with dysmenorrhea in Soppeng District High School. METHODS: This research uses quasi-experimental. A sample of 30 was selected by consecutive sampling that met the inclusion criteria. Samples taken are non-randomized pre-posttest one-group design with accidental sampling method. Data collection using numeric rating scale measurement tools. Data were not normally distributed by analyzing the Wilcoxon test. RESULTS: The results showed that the characteristics of respondents for age were 14–15 years as many as 16 (53.3%). Based on grade level, the average respondent in class one also had details of 16 (53.3%). The average pain intensity before and after intervention, where the mean value + SD is 0.67 + 0.479–0.27 + 0.450 with p value (P = 0.001 <0.05) which means that there is a difference in the average pain intensity significant before and after therapeutic interventions were given. Celery therapy and abdominal stretching exercise need to be recommended to be used as therapy to treat primary dysmenorrhea in young women at SMAN 1 Watan Soppeng. CONCLUSION: Based on the results of research and hypotheses, it can be concluded that there are significant differences after therapy which means that the administration of celery therapy and abdominal stretching exercise 3 times before menstruation is more effective in reducing pain.

Clinical efficacy and safety of a novel controlled-release morphine suppository and subcutaneous morphine in cancer pain: a randomized evaluation.

1995 ◽  
Vol 13 (6) ◽  
pp. 1520-1527 ◽  
Author(s):  
E Bruera ◽  
R Fainsinger ◽  
K Spachynski ◽  
N Babul ◽  
Z Harsanyi ◽  
...  
Keyword(s):  
Controlled Release ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Clinical Efficacy ◽  
Oral Morphine ◽  
Mcgill Pain Questionnaire ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Patients With Cancer ◽  
Significant Difference

PURPOSE A significant number of cancer patients will require an alternate route of morphine administration at some point during their illness. This study compared the clinical efficacy and safety of a novel morphine sulfate controlled-release suppository (MS-CRS) and subcutaneous (SC) morphine in patients with cancer pain. METHODS Thirty patients with cancer pain were randomized in a double-blind crossover study to MS-CRS every 12 hours or SC morphine every 4 hours for 4 days each, using a 2.5:1 analgesic equivalence ratio. Pain intensity was assessed using a visual analog scale (VAS) and the Present Pain Intensity Index of the McGill Pain Questionnaire. Nausea and sedation were also assessed with a VAS. Evaluations were made by the patient at 8 AM, noon, 4 PM, and 8 PM and rescue morphine consumption recorded. RESULTS Twenty-three patients completed the study (13 men and 10 women; mean age, 64.0 +/- 2.0 years) and were treated with mean daily MS-CRS and SC morphine doses of 326 +/- 69 mg and 138 +/- 28 mg, respectively. There was a small but significant difference in overall ordinal pain-intensity scores in favor of MS-CRS (0.7 +/- 0.1 v 0.9 +/- 0.1, P = .0459). There were no significant differences between MS-CRS and SC morphine in overall VAS scores for pain intensity (13 +/- 3 v 13 +/- 3 mm), sedation (23 +/- 3 v 25 +/- 4 mm), and nausea (8 +/- 2 v 9 +/- 2 mm). The mean daily rescue analgesic consumption during MS-CRS and SC morphine did not differ significantly (1.2 +/- 0.4 v 1.2 +/- 0.4 doses/d). CONCLUSION MS-CRS, administered every 12 hours, provides analgesia comparable to SC morphine and represents a reliable, noninvasive alternative method of pain control for patients unable to take oral morphine.

Effectiveness of opioid rotation in the control of cancer pain: The ROTODOL Study

2014 ◽  
Vol 10 (6) ◽  
pp. 395 ◽  
Author(s):  
Jesús González-Barboteo, MD ◽  
Xavier Gómez-Batiste Alentorn, MD, PhD ◽  
Felipe A. Calvo Manuel, MD, PhD ◽  
Vicente Alberola Candel, MD ◽  
M. Amalia Palacios Eito, MD ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Breakthrough Pain ◽  
Numerical Rating Scale ◽  
Gastrointestinal Symptoms ◽  
Tertiary Hospital ◽  
Opioid Rotation ◽  
Average Pain ◽  
Control Pain

Objective: To assess the effectiveness of opioid rotation (OR) to manage cancer pain. To describe the adverse events (AEs) associated with OR. Setting: Thirty-nine tertiary hospital services.Patients: Sixty-seven oncological patients with cancer-related pain treated at outpatient clinics.Intervention: Prospective multicenter study. Pain intensity was scored using a Numerical Rating Scale (NRS) of 0-10. Average pain (AP) intensity in the last 24 hours, breakthrough pain (BTP), and the number of episodes of BTP on the days before and 1 week after OR were assessed. The pre-OR and post-OR opioid were recorded. The presence and intensity of any AEs occurring after OR were also recorded.Results: In the 67 patients evaluated, 75 ORs were recorded. In all cases, the main reason for OR was poor pain control. Pain intensity decreased by ≥2 points after OR in 75.4 percent and 57.8 percent of cases for AP and BTP, respectively. If the initial NRS score was ≥4, a decrease below <4 accounted for 50.9 percent and 32.3 percent of cases for AP and BTP, respectively. The number of episodes of BTP also decreased significantly (p < 0.001). A total of 107 AEs were reported, most of which were mild in intensity, with gastrointestinal symptoms predominating.Conclusions: Opioid rotation appears to be both safe and effective in the management of basal and breakthrough cancer pain.

scholarly journals Acute Postoperative Pain in Trauma Patients - The Fifth Vital Sign

2017 ◽  
Vol 5 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Nikolina Farčić ◽  
Ivana Barać ◽  
Stana Pačarić ◽  
Ivana Lovrić ◽  
Vesna Ilakovac
Keyword(s):  
Hospital Admission ◽  
Pain Intensity ◽  
Medical Staff ◽  
Rating Scale ◽  
Pain Treatment ◽  
Numerical Rating Scale ◽  
Trauma Surgery ◽  
Trauma Patients ◽  
Average Pain Intensity ◽  
Average Pain

AIM: To determine average pain intensity perceived by trauma patients at hospital admission, lowest and highest pain intensity during their hospitalisation and their satisfaction with provided pain treatment.PATIENTS AND METHODS: The research included 114 operated patients at the Clinical Department of Trauma Surgery. We used the standard Numerical Rating Scale (NRS) for a clinical measure of pain.RESULTS: The average pain intensity at hospital admission was NRS median 7 (range 4–10), the severest perceived rate of pain during hospitalisation was NRS median 5 (range 4–7). Ninety-four percent of our respondents were satisfied with provided pain treatment. Thirty-two percent of patients were not asked to assess their pain during their hospitalisation, and 40.4% of patients assessed their pain occasionally.CONCLUSION: Female patients, as well as patients admitted to the emergency department, reported higher NRS scores. Those respondents who perceived severe pain answered more often that medical staff didn’t ask them to assess their pain on any occasion. Good communication between medical staff and patients, together with adequate assessment and evaluation of acute pain are of great importance in its treatment.

scholarly journals A prospective cohort register-based study of chronic postsurgical pain and long-term use of pain medication after otorhinolaryngological surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nina Graf ◽  
Katharina Geißler ◽  
Winfried Meißner ◽  
Orlando Guntinas-Lichius
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Postsurgical Pain ◽  
Average Pain Intensity ◽  
Chronic Postsurgical Pain ◽  
Average Pain ◽  
Patients At Risk ◽  
Perioperative Assessment ◽  
Numeric Rating

AbstractData on chronic postsurgical pain (CPSP) after otorhinolaryngological surgery are sparse. Adult in-patients treated in 2017 were included into the prospective PAIN OUT registry. Patients’ pain on the first postoperative day (D1), after six months (M6) and 12 months (M12) were evaluated. Determining factor for CPSP was an average pain intensity ≥ 3 (numeric rating scale 0–10) at M6. Risk factors associated with CPSP were evaluated by univariate and multivariate analyses. 10% of 191 included patients (60% male, median age: 52 years; maximal pain at D1: 3.5 ± 2.7), had CPSP. Average pain at M6 was 0.1 ± 0.5 for patients without CPSP and 4.2 ± 1.2 with CPSP. Average pain with CPSP still was 3.7 ± 1.1 at M12. Higher ASA status (Odds ratio [OR] = 4.052; 95% confidence interval [CI] = 1.453–11.189; p = 0.007), and higher minimal pain at D1 (OR = 1.721; CI = 1.189–2.492; p = 0.004) were independent predictors of CPSP at M6. Minimal pain at D1 (OR = 1.443; CI = 1.008–2.064; p = 0.045) and maximal pain at M6 (OR = 1.665; CI = 1.340–2.069; p < 0.001) were independent predictors for CPSP at M12. CPSP is an important issue after otorhinolaryngological surgery. Better instrument for perioperative assessment should be defined to identify patients at risk for CPSP.

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