title: Hypodermoclysis for the administration of fluids and narcotic analgesics in patients with advanced cancer.
abstract: Fifty-eight consecutive patients with advanced cancer who required parenteral hydration were treated with hypodermoclysis. A solution of two-thirds 5% dextrose and one-third saline was used in all cases at a rate of 20-100 cc/hr, with 750 units of hyaluronidase per liter, and 20-40 mEq KCl/L were administered in all patients. In 38 patients, morphine (21 cases) or hydromorphone (17 cases) were added. The mean duration of infusion and volume were 14 +/- 9 days and 1.3 +/- 0.8 L/day, respectively (range, 0.5-3 L/day). Mean dose of KCl was 25 +/- 8 mEq/L. The reason for discontinuation was death in 43 cases, oral hydration in 12 cases, and need for fluid restriction in 3 cases. Toxicity consisted in local infection in two cases and bruising in two cases. We conclude that hypodermoclysis is a safe and effective method of hydration in patients with advanced cancer.
authors.forename: E
authors.initials: E
authors.lastname: Bruera
authors.forename: M A
authors.initials: MA
authors.lastname: Legris
authors.forename: N
authors.initials: N
authors.lastname: Kuehn
authors.forename: M J
authors.initials: MJ
authors.lastname: Miller
mesh_terms: D000368:Aged; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007263:Infusions, Parenteral / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage* / Q000627:therapeutic use; D009369:Neoplasms / Q000451:nursing / Q000503:physiopathology* / Q000628:therapy; D010146:Pain / Q000188:drug therapy*
chemical_list: D009294:Narcotics