Research Articles

      Abstract    

        

COMPARATIVE EVALUATION OF EFFICACY OF STANDARD ANALGESICS IN PALLIATION OF CANCER PAIN

 

AR Simon, PL Palatty*, S Abraham, KR Thilakchand, T George, S Rao, MS Baliga

 

ABSTRACT:Background: Pain is a prevalent symptom experienced by cancer patients and its management in most set up has been weak. In the present study, we assessed the efficacy of the analgesics in cancer patients with pain. Methods: This was a prospective study and was done with cancer patients with severe pain. The patients were asked to rate the severity of the pain on the Numeric Rating Scale (NRS) score and prescribed with the standard analgesic drug. They were then again asked to rate the decrease in the pain at various post drug administration time (15 min to 3 hr) using the NRS. Results: It was found that the out of 150 patients, 73 received tab morphine (10 mg orally every 4 hrs), 42 patients received a combination of tramadol and paracetamol (32.5mg+325mg) 8th hr, 15 patients received tab tramadol (50mg) 8th hr, 12 patients received tab paracetamol (500mg) 8th hr, 8 patients who were in very severe pain received morphine 10 mg iv diluted in 100ml normal saline and given every 4th hourly. Morphine was the analgesic of choice for mitigating severe cancer pain. The non-steroidal anti-inflammatory agents (NSAID) either alone or in combination with a weak opioid was also found to be effective in reducing medium pain.  Conclusion: Analgesic therapy alleviates cancer pain in its multitude form. Morphine was the most common analgesic used with the NRS ranging from severe to very severe and found to be very useful.

KEY WORDS: Pain; analgesics; Numeric Rating Scale; morphine; tramadol; paracetamol

REFERENCES:

  1. Paice JA and Ferrell B. The Management of Cancer Pain. CA Cancer J Clin 2011: 157–182.

  2. Upp J, Kent M, Tighe PJ. The evolution and practice of acute pain medicine. Pain Med. 2013; 14:124-44.

  3. Wiffen PJ, Wee B, Moore RA. Oral morphine for cancer pain. Cochrane Database Syst Rev. 2016; 4:CD003868. doi: 10.1002/14651858.

  4. Ray JG, Ganguly M, Rao BS, Mukherjee S, Mahato B, Chaudhuri K. Clinico- epidemiological profile oral potentially malignant and malignant conditions among areca nut, tobacco alcohol users Eastern India: A hospital based study. J Oral Maxillofac Pathol. 2013; 17:45-50.

  5. Mercadante S, Prestia G, Ranieri M, Giarratano A, Casuccio Opioid use and effectiveness of its prescription at discharge in acute pain relief and palliative care unit. Support Care Cancer. 2013; 21:1853-9.

  6. Moulin DE, Amireh R,Sharpe D,Merskey H,Iezzi A,. Randomised trial oral morphine for chronic non-cancer pain. The Lancet 347; 8995: 1996, 143–146.

  7. Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015 Sep 28;(9):CD008659. doi: 10.1002/14651858.

  8. Peloso PM, Fortin L, Beaulieu A, Kamin M, Rosenthal N; Protocol TRP-CAN-1 Study Group. Analgesic efficacy and safety of tramadol/ acetaminophen combination tablets (Ultracet) in treatment of chronic low back pain: a multicenter, outpatient, randomized, double blind, placebo controlled trial. J Rheumatol. 2004; 31:2454-63.

  9. Mullican WS, Lacy JR. Tramadol/acetaminophen combination tablets codeine/ acetaminophen combination capsules for management chronic pain: a comparative trial. Clinical Therapeutics 2001: 23;1429–1445.

  10. Houmes RJ, Voets MA, Verkaaik A, Erdmann W, Lachmann B. Efficacy and safety of tramadol versus morphine for moderate and severe postoperative pain with special regard to respiratory depression. Anesth Analg. 1992; 74(4):510-4.

  11. Grond S, Radbruch L, Meuser T, Loick G, Sabatowski R, Lehmann KA. High-dose tramadol in comparison to low-dose morphine for cancer pain relief. J Pain Symptom Manage. 1999; 18(3):174-9.

  12. Stockler M, Vardy J, Pillai A, Warr D. Acetaminophen (paracetamol) improves pain and well-being in people with advanced cancer already receiving a strong opioid regimen: a randomized, double-blind, placebo-controlled cross-over trial. J Clin Oncol. 2004 15; 22(16): 3389-94.

  13. Nelson KA, Glare PA, Walsh D, Groh ES. A prospective, within-patient, crossover study of continuous intravenous and subcutaneous morphine for chronic cancer pain. J Pain Symptom Manage. 1997; 13(5):262-7.

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