RESUMO
Oral mucositis (OM) pain is an anticipated complication of immunosuppressive therapies for hematological malignancies. Opioids are effective for OM-associated pain and dysfunction that is refractory to simple measures. At the study institution, parenteral opioids are preferentially prescribed for the treatment of complicated OM. This audit explores the efficacy of opioids for the management of OM pain using morphine, oxycodone, and fentanyl patient-controlled analgesia (PCA). Pain scores, opioid consumption, resumption of oral intake, and the duration of admission were retrospectively analyzed from patient records over an 18-month period. Two-thirds of included patients had ceased PCA therapy by day 6, by which time there was a meaningful 35.4 percent reduction in pain scores, with very few side effects reported. Interagent comparison demonstrated no significant differences in mean daily pain scores; however, a larger sample size would facilitate an investigation of clinically significant nuances in treatment differences, if they exist.
Assuntos
Neoplasias Hematológicas , Estomatite , Analgesia Controlada pelo Paciente/efeitos adversos , Analgésicos Opioides/efeitos adversos , Neoplasias Hematológicas/induzido quimicamente , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/tratamento farmacológico , Humanos , Morfina/efeitos adversos , Dor/tratamento farmacológico , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Estudos Retrospectivos , Estomatite/diagnóstico , Estomatite/tratamento farmacológico , Estomatite/etiologiaRESUMO
Following surgery there is often a need for ongoing pain management after the patient is discharged from hospital. This can be made easier if the patient has an appropriate discussion before leaving hospital about what pain they can expect, and they are given a management plan Paracetamol and non-steroidal anti-inflammatory drugs are suitable for most patients. Drugs with a short half-life, such as ibuprofen, may need to be taken regularly Short-acting opioids can have a short-term role, providing guidelines are followed. There is a predictable period of time after surgery when the benefit of an opioid is expected to be maximised before harmful adverse effects will dominate Gabapentinoids are useful for neuropathic pain, but have a limited role in nociceptive pain. Like opioids, they have a risk of misuse The surgeon should be consulted if the patient develops new pain or the postoperative pain becomes more severe Most postsurgical pain will resolve within three months. If not, it is deemed persistent pain that may warrant specialist assessment