title: Efficacy of epidural analgesia in patients with cancer pain: a retrospective observational study.
abstract: OBJECTIVE
  Pain in terminal cancer patients may be refractory to systemic analgesics or associated with adverse drug reactions to analgesics. Epidural analgesia has been effectively used in such patients for pain control. However, this method does not provide pain relief to all patients. The efficacy and complications of continuous epidural analgesia were evaluated for expanding efficacy in terminal cancer patients.
  
  
  METHODS
  The charts of patients who received epidural analgesia for over 5 years for the control of terminal cancer pain were reviewed retrospectively.
  
  
  RESULTS
  Ninety-six patients received 127 epidural catheters. The mean duration for epidural catheterization was 31.5±55.6 (5-509) days. The dose of epidural morphine increased by 3.5% per day. The efficacy of epidural analgesia at 2 weeks follow up revealed improved pain control (n=56), as the morphine equivalent drug dose dropped from 213.4 mg/day to 94.1 mg/day (p<0.05) at 2 weeks follow up. Accordingly, after 2 weeks institution of epidural analgesia, there was a significant reduction in the proportion of patients with severe pain, from 78.1% to 19.6% (p<0.05).
  
  
  CONCLUSIONS
  Epidural analgesia was an effective pain control method in patients with terminal cancer pain, however, a systematized algorithm for the control of cancer-related pain in needed.
authors.affiliation: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 442-723, Korea.
authors.forename: Yeon Soo
authors.initials: YS
authors.lastname: Jeon
authors.forename: Jung Ah
authors.initials: JA
authors.lastname: Lee
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Choi
authors.forename: Eu Gene
authors.initials: EG
authors.lastname: Kang
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Jung
authors.forename: Hoon Kyo
authors.initials: HK
authors.lastname: Kim
authors.forename: Byoung Yong
authors.initials: BY
authors.lastname: Shim
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Park
authors.forename: Jin Deok
authors.initials: JD
authors.lastname: Joo
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D002045:Bupivacaine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D009020:Morphine; D002045:Bupivacaine