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2001, Number 2

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Rev Mex Anest 2001; 24 (2)

Evaluación de latencia y duración de la analgesia de una dosis individual de morfina peridural para el manejo del paciente con dolor crónico oncológico agudizado

Núñez QG, Hernández SJR, Tenopala VS, Canseco AC, Rivera LG, Torres HJC, Zepeda VTC, Martínez AR, Ocampo AL, Velázquez RV

Language: Spanish
References: 16
Page:
PDF size: 46.05 Kb.


ABSTRACT

Background: Assessment of latency and duration of a single dose of epidural morphine for analgesia in patients with severe oncologic chronic pain. Main goal: Establish an epidural morphine-sulfate single dose in order to manage patients with severe oncologic chronic pain, contemplating analgesic duration, latency and side effects. Material and Methods: The study was carried out on 30, both male and female patients, aging from 30 to 70 years, with severe oncologic chronic pain of VAS 7 or higher, which were were divided into 3 groups of 10 patients each; every one of them received a single epidural morphine sulfate bolus: first group 30 mcg/kg, second group 50 mcg/kg and third group 75 mcg/kg. Latency and duration of such dose was assessed at 5´,10´,15´,20´,40´,60´ and 2,3,4,5,6 and later every 2 hours until the patient manifested pain again. The analgesic quality was assessed by means of Visual Analogue Scale (VAS). Vitals constant (heart rate, respiratory rate, blood pressure) were registered at the same time. Results: 30 patients, 18 female (60%) and 12 male (40%) were studied, aging 58.3 years on average. During the study a better pain management was found upon diminishing the basal values from 8.4 to 3.8 in group I, from 8.4 to 3.9 in group II from 8.3 to 3.4 in group II. The latency in the first group was 14 ±1.5 minutes with a duration of 417 ±29.8, in the second group 15.1 ± 6.1 minutes with a duration of 459 ± 6.1 and in the third group 9.5 ±1.0 minutes with a duration of 648 ±120.1. The most evident side effects were nausea, vomiting, pruritus, urinary retention and constipation, which were more frequent in patients of the third group. Discusion: We consider that the dose of epidural morphine in single dose that provides acceptable analgesia, adequate duration and fewer side effects was 50 mcg/kg. Therefore, it could be regarded as an alternative option for managing the pain in patients with severe oncologic chronic pain.


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