Abstract 532P
Background
Pain is a common symptom affecting patients with cancer. In clinical practice patients with advanced refractory cancer pain often face multiple anti-tumor treatments , pain relief and drug management are challenging. Patient-controlled analgesia (PCA) is an essential component of the WHO's "four-step" analgesic treatment. However, difficulties associated with PCA configuration, unified pump configuration mode, and tube blockage may negatively affect large-scale promotion of PCA technology in hospitals and at home.In this study we optimized PCA parameters to enhance the practicality and feasibility of the pump to evaluate the effect and to explore its convenience in home use.
Methods
A total of 100 patients with refractory cancer pain were included in this study. The pump configuration mode was divided into two stages. The first (titration) stage was: hydromorphone + normal saline with a total volume of 24 ml and pump speed of 1.0 ml/h. The second (maintenance) stage was: hydromorphone + normal saline with a total volume of 288 ml and pump speed of 1.2 ml/h with PCA of 2.4 ml. During the maintenance stage, if pain control was unsatisfactory the background dose was increased based on the number of PCA presses in the previous 24 hours. Patients' numeric rating scale (NRS) scores, quality of life scores, and adverse reactions were recorded before and after treatment.
Results
Patients' average NRS score before treatment was 7.4 (7-10). Average time to successful titration was 49.6 minutes (35.6-56.9) and 40.7% of patients achieved successful titration within 30 minutes. After titration, the average NRS score was 3.2 (0-6). During maintenance, 56.0% of patients experienced breakthrough pain on day 1, when the average NRS score was 5.2. As background dosing continued breakthrough pain and average NRS score gradually decreased (p<0.05). Quality of life scores and patient satisfaction measured before and after 10 days of PCA pump use showed significant improvement (p<0.001).
Conclusions
Hydromorphone PCA "10-day simple mode" produces good analgesic effect, is easy to manage, and suitable for patients seeking home-based pain relief. This simple model is worth promoting in clinical practice.
Clinical trial identification
NCT05744089.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Xinxiang Medical University Education Foundation.
Disclosure
All authors have declared no conflicts of interest.