scholarly journals Morphine use for cancer pain: A strong analgesic used only at the end of life? A qualitative study on attitudes and perceptions of morphine in patients with advanced cancer and their caregivers

2020 ◽  
Vol 34 (5) ◽  
pp. 619-629
Author(s):  
Julia Fee Voon Ho ◽  
Hayati Yaakup ◽  
Grace Sook Hoon Low ◽  
Siew Lih Wong ◽  
Lye Mun Tho ◽  
...  
Keyword(s):  
Side Effects ◽  
Qualitative Study ◽  
Cancer Pain ◽  
Advanced Cancer ◽  
Pain Control ◽  
Opioid Analgesics ◽  
Tertiary Hospital ◽  
Advanced Cancer Patients ◽  
Attitudes And Perceptions ◽  
Patients Acceptance

Background: The prevalence of undertreated cancer pain remains high. Suboptimal pain control affects quality of life and results in psychological and emotional distress. Barriers to adequate pain control include fear of opioid dependence and its side effects. Aim: To investigate the attitudes and perceptions of morphine use in cancer pain in advanced cancer patients and their caregivers and to examine the influence of caregivers’ attitudes and perceptions on patients’ acceptance of morphine. Design: Qualitative study involving semi-structured individual interviews transcribed verbatim and analyzed thematically. Setting/Participants: A total of 18 adult opioid-naïve patients with advanced cancer and 13 caregivers ( n = 31) were recruited at a private tertiary hospital via convenience sampling. Results: Attitudes and perceptions of morphine were influenced by previous experiences. Prevalent themes were similar in both groups, including perceptions that morphine was a strong analgesic that reduced suffering, but associated with end-stage illness and dependence. Most participants were open to future morphine use for comfort and effective pain control. Trust in doctors’ recommendations was also an important factor. However, many preferred morphine as a last resort because of concerns about side effects and dependence, and the perception that morphine was only used at the terminal stage. Caregivers’ attitudes toward morphine did not affect patients’ acceptance of morphine use. Conclusion: Most participants were open to future morphine use despite negative perceptions as they prioritized optimal pain control and reduction of suffering. Focused education programs addressing morphine misperceptions might increase patient and caregiver acceptance of opioid analgesics and improve cancer pain control.

scholarly journals Cancer Pain Control for Advanced Cancer Patients by Using Autonomic Nerve Pharmacopuncture

2014 ◽  
Vol 17 (3) ◽  
pp. 62-69 ◽  
Author(s):  
Hwi-joong Kang ◽  
Jung-won Yoon ◽  
Ji-hye Park ◽  
Chong-kwan Cho ◽  
Hwa-seung Yoo
Keyword(s):  
Cancer Pain ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Pain Control ◽  
Autonomic Nerve ◽  
Advanced Cancer Patients

scholarly journals Patient-Controlled Intravenous Analgesia for Advanced Cancer Patients with Pain: A Retrospective Series Study

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Zhiyou Peng ◽  
Yanfeng Zhang ◽  
Jianguo Guo ◽  
Xuejiao Guo ◽  
Zhiying Feng
Keyword(s):  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Medical Records ◽  
Analgesic Effect ◽  
Advanced Cancer Patients ◽  
Significant Difference ◽  
Intravenous Analgesia ◽  
Series Study

Objective. To compare the efficacy and side effects of patient-controlled intravenous analgesia (PCIA) with hydromorphone, sufentanil, and oxycodone on the management of advanced cancer patients with pain. Methods. Patients allocated to receive PCIA between January 2015 and December 2016 were chosen for this study. After reviewing medical records, we verified if hydromorphone, sufentanil, or oxycodone for PCIA could equally provide effective pain relief. A numeric rating scale (NRS) of cancer pain was applied before PCIA, at 4 hours after PCIA, and at the discontinuation of PCIA. Secondary, the incidence of clinical side effects attributed to PCIA was observed. Results. A total of 85 medical records were reviewed. PCIA with hydromorphone (n=30), sufentanil (n=34), and oxycodone (n=21) was used for cancer pain management. PCIA successfully improved pain control in 97.6% of the patients. The most common side effects were constipation (11.8%), nausea (8.2%), and sedation (5.9%). Drug addiction, delirium, or respiratory depression associated with PCIA was not reported in this case series study. No significant intergroup difference was observed in NRS at any of the abovementioned time points. There was no significant difference of analgesic effect among the hydromorphone, sufentanil, or oxycodone. Conclusion. PCIA provided timely, safe, and satisfactory analgesia for advanced cancer patients with pain and may be useful for titration of opioids, management of severe breakthrough pain, and conversion to oral analgesia. There was no significant difference of analgesic effect and side effect among the hydromorphone, sufentanil, and oxycodone.

scholarly journals Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yinxia Wang ◽  
Ligang Xing
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Control ◽  
Analgesic Drugs ◽  
Oxycodone Hydrochloride ◽  
Radiation Esophagitis

Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be combined with analgesic drugs in clinical guidelines. Previous studies have shown that radiotherapy combined with oxycodone hydrochloride can effectively alleviate cancer pain. In this review, we firstly presented the necessity of analgesia during the whole course of radiotherapy. We also sketched the role of oxycodone hydrochloride in radiotherapy of bone metastases and radiotherapy-induced oral mucositis. Finally, we concluded that oxycodone hydrochloride shows good efficacy and tolerance and could be used for pain management before, during, and after radiotherapy.

Quality of life domains important and relevant to family caregivers of advanced cancer patients in an Asian population: a qualitative study

2014 ◽  
Vol 24 (4) ◽  
pp. 817-828 ◽  
Author(s):  
Geok Ling Lee ◽  
Mandy Yen Ling Ow ◽  
Ramaswamy Akhileswaran ◽  
Grace Su Yin Pang ◽  
Gilbert Kam Tong Fan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Asian Population ◽  
Life Domains ◽  
Advanced Cancer Patients

Pain Management

2018 ◽  
Author(s):  
Eelco F. M. Wijdicks ◽  
Sarah L. Clark
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Management ◽  
Side Effects ◽  
Pain Control ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Narcotic Analgesics

Adequate pain control has a high priority. In any acute neurologic pain syndrome it must be assumed that pain management is possible, effective, and simple; unfortunately, most patients in pain have been poorly managed. The pharmacopeia of pain management is growing and changing and several trends have been noted. Pain is underreported in the intensive care unit and should be treated when indicated. Acetaminophen is often the first agent used in pain management. Next are weak narcotic analgesics which could have less severe side effects than stronger opioid analgesics. This chapter discusses types of pain in the neurosciences intensive care unit and specific pharmacologic approaches.

Placebo and nocebo effects in randomized double-blind clinical trials for fatigue in advanced cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9640-9640
Author(s):  
M. de la Cruz ◽  
D. Hui ◽  
H. A. Parsons ◽  
P. Lynn ◽  
C. Parker ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Side Effects ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Randomized Clinical Trials ◽  
Placebo Response ◽  
Well Being ◽  
Advanced Cancer Patients ◽  
Edmonton Symptom Assessment Scale ◽  
Nocebo Effects

9640 Background: We have previously reported significant placebo response in randomized controlled treatment trials for cancer related fatigue (CRF). We conducted a retrospective study to determine the frequency and predictors of response to placebo and nocebo effect in patients with CRF. Methods: We reviewed patients that received placebo in two previous randomized clinical trials conducted by our group and determined the proportion of patients who demonstrated clinical response to fatigue using an increase (ΔFACIT-F score) > 7 from baseline to day 8, and those with nocebo response as those who reported side effects. Baseline patient characteristics and symptoms recorded from the Edmonton Symptom Assessment Scale (ESAS) were analyzed to determine their association with placebo and nocebo effects. Results: A total of 105 advanced cancer patients received placebo. 59 (56%) patients responded to placebo (median Δ FACIT-F score of 22). Worse baseline anxiety and well-being subscale score (univariate) and well-being (multivariate, MR) were significantly associated with placebo response. Common side effects reported were insomnia (79%), anorexia (53%), nausea (38%) and restlessness (34%). MR analysis showed that worse baseline (ESAS) sleep, appetite, nausea, and restless are associated with increased reporting of these side effects ( Table ). Conclusions: Nearly half of advanced cancer patients enrolled in the fatigue trials responded to placebo. Worse physical well-being score was associated with placebo response. Patients experiencing specific symptoms at baseline were more likely to report these as side effects of the medication. These findings should be considered in fatigue clinical trial design. [Table: see text] No significant financial relationships to disclose.

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