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Patient-controlled analgesia and oral mucositis pain in hematological malignancies

Swaetha Koneru, MBBS (Hons), FANZCA, MMed (Hons), Natalie Lukas, BPhty, MBBS (Hons), Matthew Doane, MD, MPH, DABA, FANZCA, Gavin Pattullo, BMedSci, MBBS (Hons), FANZCA, FFPMANZCA, Ross MacPherson, PhD, FANZCA


Oral mucositis (OM) pain is an anticipated complication of immunosuppressive therapies for hematological malignancies. Opioids are effective for OM-associated pain and dysfunction that is refractory to simple measures. At the study institution, parenteral opioids are preferentially prescribed for the treatment of complicated OM.

This audit explores the efficacy of opioids for the management of OM pain using morphine, oxycodone, and fentanyl patient-controlled analgesia (PCA). Pain scores, opioid consumption, resumption of oral intake, and the duration of admission were retrospectively analyzed from patient records over an 18-month period. Two-thirds of included patients had ceased PCA therapy by day 6, by which time there was a meaningful 35.4 percent reduction in pain scores, with very few side effects reported. Interagent comparison demonstrated no significant differences in mean daily pain scores; however, a larger sample size would facilitate an investigation of clinically significant nuances in treatment differences, if they exist.



acute pain, cancer pain, patient-controlled analgesia

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