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American Society for Action on Pain |
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UI - 000252 AU - Hogan O AU - Weissman DE AU - Haddox JD AU - Abram S AU - Taylor ML AU - Janjan N TI - EPIDURAL OPIATES AND LOCAL ANESTHETICS FOR THE MANAGEMENT OF CANCER PAIN (MEETING ABSTRACT) AB - AB - The Medical College of Wisconsin multispecialty cancer pain service reviewed its experiences with epidural analgesia by retrospectively reviewing hospital/clinic charts from January 1987 through December 1989. 1205 patients (pts) were admitted to the inpatient oncology service during the study period, and epidural analgesia was used 16 times (15 pts, 1.2%). Indications for epidural analgesia included failure of systemic opioids and other noninvasive drug and nondrug therapies per WHO guidelines. The mean pre- epidural equianalgesic dose of im morphine was 300 mg/day. Temporary catheters were used to assess response to epidural morphine; if no response bupivacaine was added; if no response the catheter was removed; if analgesia was obtained the temporary catheter was replaced by a tunneled catheter for long-term use. Analgesia was successfully obtained in 12/16 epidural attempts; 6 with morphine alone, 6 with morphine plus bupivacaine. 4/16 attempts were discontinued due to unacceptable toxicity or technical problems. Tunneled catheters were used for a mean of 83 days (range 6-965 days). Catheter problems included malfunction (7), infection (4), injection pain (4), epidural hematoma (1), hyperesthesia (1). Epidural analgesia is infrequently indicated, bupivacaine extends the efficacy of epidural analgesia and complications are common AD - Medical Coll. of Wisconsin AD - Milwaukee AD - WI 53211 UI - 91672498 SO - Proc Annu Meet Am Soc Clin Oncol 1991;10:A1161-A116 |