Patient-controlled analgesia and oral mucositis pain in hematological malignancies

Authors

DOI:

https://doi.org/10.5055/jom.2022.0726

Keywords:

acute pain, cancer pain, patient-controlled analgesia

Abstract

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.

 

Author Biographies

Swaetha Koneru, MBBS (Hons), FANZCA, MMed (Hons)

Royal North Shore Hospital, Sydney, New South Wales, Australia

Natalie Lukas, BPhty, MBBS (Hons)

Royal North Shore Hospital, Sydney, New South Wales, Australia

Matthew Doane, MD, MPH, DABA, FANZCA

Staff Specialist Anesthesiologist, Department of Anaesthesia and Pain Management, Royal North Shore Hospital, Sydney, New South Wales, Australia; Departmental Head, Academics & Research, Royal North Shore Hospital, Sydney, New South Wales, Australia; Department Head & Conjoint Senior Lecturer, Academics & Research, Sydney University Medical School, University of Sydney, Sydney, New South Wales, Australia

Gavin Pattullo, BMedSci, MBBS (Hons), FANZCA, FFPMANZCA

Director, Acute Pain Service, Department of Anaesthesia and Pain Management, Royal North Shore Hospital, Sydney, New South Wales, Australia; Clinical Senior Lecturer, Anaesthesia, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia

Ross MacPherson, PhD, FANZCA

Clinical Professor, Senior Staff Specialist Anesthesiologist, Department of Anaesthesia and Pain Management, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia

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Published

07/01/2022

How to Cite

Koneru, MBBS (Hons), FANZCA, MMed (Hons), S., N. Lukas, BPhty, MBBS (Hons), M. Doane, MD, MPH, DABA, FANZCA, G. Pattullo, BMedSci, MBBS (Hons), FANZCA, FFPMANZCA, and R. MacPherson, PhD, FANZCA. “Patient-Controlled Analgesia and Oral Mucositis Pain in Hematological Malignancies”. Journal of Opioid Management, vol. 18, no. 4, July 2022, pp. 309-16, doi:10.5055/jom.2022.0726.