1327 - Simultaneous intravenous fluid infusion to prevent oxaliplatin infusion-related venous pain

Background

Oxaliplatin is frequently used in the treatment of gastrointestinal cancer patients. A known side effect of oxaliplatin administration via a peripheral vein is infusion-related pain. In this retrospective cohort study we compared the incidence of infusion-related pain in patients treated with oxaliplatin with or without simultaneous fluid infusion (FI) (800 ml glucose 5% in 2 hours).

Methods

As of December 2017, all patients treated with oxaliplatin at the Jeroen Bosch Hospital in the Netherlands received simultaneous FI. We retrospectively defined two cohorts: Patients treated with oxaliplatin and simultaneous intravenous FI starting treatment between January and November 2018, and the same number of patients treated without FI between January and November 2017. The incidence of infusion-related venous pain was the primary outcome measure. Secondary outcomes included: Incidence of hypersensitivity reactions, infusion time, dose density, the number of patients switched to a central venous catheter and the incidence of peripheral neuropathy. Chi-square tests for categorical variables and T- tests for continuous variables were used. To identify possible confounders, we conducted a multivariate logistic regression analysis.

Results

100 patients were included: 50 patients in the FI group, 50 patients in the group treated without FI. Baseline characteristics were comparable, except for age (median 66.8 versus 62.4 years in groups with and without FI; p = 0.017), and BMI (28.0 versus 25.7 kg/m2 respectively; p = 0.012). Patients treated with simultaneous FI experienced significantly less vascular pain compared to those without FI (10% versus 78% respectively (p < 0.0001; OR 0.031 (95% CI: 0.01-0.098)). No difference was observed in dose density, treatment delay, or the need of central venous catheter. Multi-variate regression analysis showed no confounders affecting the primary outcome. No adverse events of FI were observed.

Conclusions

Concurrent infusion of 800ml glucose 5% with peripheral venous administration of oxaliplatin significantly reduces the incidence of infusion-related pain in gastrointestinal cancer patients and is highly feasible and affordable in every-day clinical practice.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.