Lisa Nijland1, Pia Schmidt1, Michael Frosch1, Julia Wager1, Bettina Hübner-Möhler1, Ross Drake2, Boris Zernikow3. 1. Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Dr.-Friedrich-Steiner Str. 5, 45711, Datteln, Germany. 2. Starship Children's Health, Auckland, New Zealand. 3. Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Dr.-Friedrich-Steiner Str. 5, 45711, Datteln, Germany. b.zernikow@kinderklinik-datteln.de.
Abstract
CONTEXT: Opioids administered by various routes are a mainstay of tumour-related pain management. Subcutaneous or intravenous patient-controlled analgesia (PCA) with opioids is an appropriate and safe form of treatment for postoperative pain but studies on this form of administration are sparse in the setting of cancer pain despite widespread use. OBJECTIVE: To evaluate the published studies on opioids administered by subcutaneous and intravenous patient-controlled analgesia for patients with cancer pain. METHODS: Articles were identified from the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 7, 2016), PubMed (Medline; 1975 to 2016) and EMBASE (1974 to 2016). Additional reports were identified from the reference lists of retrieved papers. Studies based on original data with a focus on intravenous or subcutaneous PCA administration of opioids in patients suffering from cancer-related pain were selected. The language was restricted to Dutch, English or German. Predefined information was extracted depending on the topic. RESULTS: Fifty studies published since 1980 met the inclusion criteria. A wide range of study designs, study quality and research objectives were observed. The studies indicated use of standard or by proxy PCA in the inpatient and outpatient setting were safe and useful while significant adverse effects were rarely observed. CONCLUSION: This systematic review of the current evidence suggests PCA can be appropriately used in a wide range of clinical situations.
CONTEXT: Opioids administered by various routes are a mainstay of tumour-related pain management. Subcutaneous or intravenous patient-controlled analgesia (PCA) with opioids is an appropriate and safe form of treatment for postoperative pain but studies on this form of administration are sparse in the setting of cancer pain despite widespread use. OBJECTIVE: To evaluate the published studies on opioids administered by subcutaneous and intravenous patient-controlled analgesia for patients with cancer pain. METHODS: Articles were identified from the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 7, 2016), PubMed (Medline; 1975 to 2016) and EMBASE (1974 to 2016). Additional reports were identified from the reference lists of retrieved papers. Studies based on original data with a focus on intravenous or subcutaneous PCA administration of opioids in patients suffering from cancer-related pain were selected. The language was restricted to Dutch, English or German. Predefined information was extracted depending on the topic. RESULTS: Fifty studies published since 1980 met the inclusion criteria. A wide range of study designs, study quality and research objectives were observed. The studies indicated use of standard or by proxy PCA in the inpatient and outpatient setting were safe and useful while significant adverse effects were rarely observed. CONCLUSION: This systematic review of the current evidence suggests PCA can be appropriately used in a wide range of clinical situations.
Authors: Robert H Dworkin; Dennis C Turk; Sarah Peirce-Sandner; Ralf Baron; Nicholas Bellamy; Laurie B Burke; Amy Chappell; Kevin Chartier; Charles S Cleeland; Ann Costello; Penney Cowan; Rozalina Dimitrova; Susan Ellenberg; John T Farrar; Jacqueline A French; Ian Gilron; Sharon Hertz; Alejandro R Jadad; Gary W Jay; Jarkko Kalliomäki; Nathaniel P Katz; Robert D Kerns; Donald C Manning; Michael P McDermott; Patrick J McGrath; Arvind Narayana; Linda Porter; Steve Quessy; Bob A Rappaport; Christine Rauschkolb; Bryce B Reeve; Thomas Rhodes; Cristina Sampaio; David M Simpson; Joseph W Stauffer; Gerold Stucki; Jeffrey Tobias; Richard E White; James Witter Journal: Pain Date: 2010-03-06 Impact factor: 6.961
Authors: Roelien H Enting; Wendy H Oldenmenger; Carin C D van der Rijt; Erik B Wilms; Erna J Elfrink; Ineke Elswijk; Peter A E Sillevis Smitt Journal: Cancer Date: 2002-06-01 Impact factor: 6.860