Management of neuropathic cancer pain following WHO analgesic ladder: a prospective study.
Cancer pain treatment according to the guidelines of World Health Organization (WHO) is effective and safe in majority of patients. 818 neuropathic cancer pain patients were enrolled in the study and pain was managed according to WHO analgesic ladder and followed up to six months. Main adjuvant drugs used were amitryptaline (29.9%), gabapentin (29.9%) and gabapentine with dexamethasone in (19.9%) and dexamethasone alone in (20.2%) patients. Opioids prescribed were mainly tramadol, codeine sulphate and morphine. 52% patients received morphine as rescue analgesic. At the end of six months 53.2% patients had no pain and 41.9% of patients had mild pain as compared to 0% and 10.2% patients respectively at the first visit. 4.9% of patients had moderate pain even after the treatment. Neuropathic cancer pain can be relieved by multimodal treatment following WHO guidelines as majority of cancer patients suffered multiple types of pain.
Mishra
Seema
S
Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. mseema17@yahoo.co.in
Bhatnagar
Sushma
S
Gupta
Deepak
D
Nirwani Goyal
Gaurav
G
Jain
Roopesh
R
Chauhan
Himanshu
H
D000328:Adult; D000588:Amines / Q000627:therapeutic use; D000639:Amitriptyline / Q000627:therapeutic use; D000700:Analgesics / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002173:Cancer Care Facilities; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D000077206:Gabapentin; D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009437:Neuralgia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014944:World Health Organization; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003509:Cyclohexanecarboxylic Acids; D000639:Amitriptyline; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D003907:Dexamethasone