Controlled-release oxycodone in the treatment of neuropathic pain of nonmalignant and malignant causes.
OBJECTIVE
To assess the efficacy and safety of controlled-release oxycodone in patients with moderate to severe neuropathic pain of nonmalignant and malignant causes.


METHODS
A retrospective observational study on the use of controlled-release oxycodone for patients with moderate to severe neuropathic pain. Records of patients treated at the Davao Doctor's Oncology Center Pain Clinic from June 2005 to June 2007 were reviewed. Sixty-seven patients with moderate to severe neuropathic pain despite treatment with adjuvant analgesics (anticonvulsants and antidepressants), who therefore received controlled-release oxycodone, were identified: 35 patients had neuropathic pain not related to a malignancy, and 32 patients had neuropathic pain secondary to a malignancy. Baseline pain intensity and pain intensity on follow-up after 2-4 weeks of treatment were recorded using a Visual Analog Scale.


RESULTS
Among patients with nonmalignant neuropathic pain, the baseline Visual Analog Scale score was 8-10/10, with improvement in pain score to 0-2/10 in 96% on follow-up. Average daily dose of oxycodone was 25 mg/day. Patients received concomitant anticonvulsants or antidepressants. Duration of treatment ranged from 2 to 8 months. Among patients with malignant neuropathic pain, the baseline Visual Analog Scale score was 10/10 with improvement to 2-4/10. Average daily dose was 40 mg per day. Patients received concomitant anticonvulsants. Duration of treatment ranged from 1 to 4 months. Oxycodone was well tolerated, with dizziness and nausea occurring only in <5%. No respiratory depression occurred.


CONCLUSIONS
The use of opioids for neuropathic pain is not fully accepted by the majority of physicians at present. This study shows that controlled-release oxycodone is a safe, well-tolerated and effective medication for neuropathic pain.
Ong
Eleanor C
EC
Davao Doctor's Oncology Center, Davao Doctor's Hospital, Davao City, Philippines. ongeleanor@yahoo.com