Effect of solution pre-warming, hot compress, plus pH adjustment by combination with dexamethasone on venous pain in cancer patients receiving oxaliplatin via a peripheral vein

Background

Central venous port-free administration of oxaliplatin in combination with an oral fluoropyrimidine improves patient satisfaction; however, pain provoked by peripheral intravenous administration of oxaliplatin may reduce compliance. There are recent reports that pH adjustment by combination with dexamethasone, pre-warming of the solution, or a hot compress over the peripheral catheterization site, reduces peripheral venous pain. To date, the therapeutic benefit of the combination of these interventions has not been established. The aim of this study was to clarify the efficacy of this combination for venous pain in cancer patients receiving oxaliplatin through a peripheral vein.

Methods

We treated all outpatients with the above combination after April 2012. The venous pain was defined as grade ≥2, according to the Common Terminology Criteria for Adverse Events version 4.0. We retrospectively reviewed the electronic medical records from cancer patients who had received oxaliplatin via a peripheral vein between December 2009 and June 2014. The study protocol was approved by the Ethics Committee of Ehime University Hospital (approval number: 1602007).

Results

We evaluated 271 treatment courses in 59 patients. Venous pain occurred in 42 courses (15.5 %) among 26 patients. Multivariate logistic regression analysis revealed that female sex and body mass index ≧25 were significantly associated with an increased risk of venous pain during all courses (adjusted odds ratio [OR]: 3.18, 95 % confidence interval [CI]: 1.35–7.92; p = 0.008 and adjusted OR: 3.37, 95 % CI: 1.27–9.40; p = 0.015, respectively). Combination of pre-warming the solution, use of a hot compress, plus pH adjustment by combining with dexamethasone were significantly associated with a reduced risk of venous pain during all courses (adjusted OR: 0.11, 95 % CI: 0.02–0.44; p = 0.002).

Conclusions

This is believed to be the first study to establish the analgesic effect of combination of pre-warming the solution, use of a hot compress, plus pH adjustment by combining with dexamethasone on venous pain in cancer patients receiving oxaliplatin through a peripheral vein.

Clinical trial identification

Legal entity responsible for the study

Ehime University Hospital

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.