2102P - Changes in opioid usage after intrathecal morphine pump implantation in patients with terminal cancer (pilot study)

Background

It is known that the prevalence of pain in terminal cancer patients reaches 70-90%, and the intensity of pain is very extreme. The intrathecal morphine pump (ITP) has been recognized for effective pain control in cancer pain, but, it is usually recommended to cancer patients with more than one year of life expentancy. This study aimed to find out the usefulness of the ITP through the change in opioid usage before and after pump implantation in patients with terminal cancer.

Methods

A total of 20 patients were included, retrospectively. Morphine equivalent daily dose (MEDD) and pain intensity (visual analogue scale, 0-10) were collected at baseline, 1, and 3months after insertion of ITP. Also, each patient’s demographic data, diagnosis, stage and type of cancer were recorded.

Results

The mean age of 20 patients is 56.2±15.9 (years) and the female was nine. In addition, patients with colorectal, advanced, and prostate cancer accounted for 60% of the patients. The duration of ITP maintenance until the death of patients was 7±10.5 months. The MEDD was increased at 3 months after implantation of ITP compared to baseline (P=0.03). In addition, the pain relief effect lasted at 3 months after the procedure (P=0.03) (Table).

Table: 2102P

Changes in morphine equivalent daily dose (MEDD) and pain intensity after intrathecal morphine pump implantation

¹Statistically significant value compared to baseline (p < 0.05). The values are expressed as the mean ± SD. VAS=visual analogue scale

Conclusions

In patients with terminal cancer requiring high doses of opioids for pain control, the use of ITP implantation can offer effective pain relief while reducing opioid toxicity and side effects. Additionally, clinical evidence suggests that ITP implantation may provide value for patients with a life expectancy of less than one year.

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.