Author/Editor		Krčevski-Škvarč, N
Title		Continuous epidural analgesia in patients with malignant diseases
Type		članek
Source		In: Stacher A, ed. Ganzheitsmedizin und schmerz. Dritter Wiener Dialog. Facultas,
Publication year		1993
Volume		str. 71-74
Language		eng
Abstract		Patients with malignant diseases frequently experience pain. As many as 4o percent of these patients are in pain already in the initial phase of the disease, 70-90 percent experience severe pain in the progressed phase of the disease (1). In the last decade, spinal epidural opioid analgesia has asserted itself succesfully as a method of pain management. With spinal introduction of opiates playing the part of exogenous transmitters, we can exert a direct influence on the receptors in the central nervous system. Due to this direct action, very good analgesia is achieved. In alleviation of pain with the administration of opiates to the spinal nerve roots by way of a catheter introduced into the epidural space, smaller doses of drugs are applied thain in the usual oral or parenteral administration of opiates. In the course of treatment side effects of varying significance may appear, but they have no effect on the applicability of this method of treatment (2,3). The article presents the successful analgetic treatment of 88 patients with malignant disease (38 men and 50 women) by means of an epidural catheter through a period of 49 +- 47 days. The patients received epidural injections of methodone in 0.125 percent bupivacaine. The initial single dose of methadone was 60 micro g/kg BW +- 0.1, the initial daily dose 120 micro g/kg BW +- 0.16 micro g/kg BW. Owing to the spread of disease and intensification of pain in the course of treatment, the daily dose was increased to 270 micro g/kg BW +- 0.16 micro g/kg BW. Among side effects, obstipation was the most frequently expressed (15 percent). Baside spinal introduction of methadone, all patients received ketoprofen 150 mg daily as well as a sedative or antidepressant (2,4). In 20 percent of all patients treated there were technical complications such as clogging or extraction of the catheter. In 25 percent of patients additonal medicamentous blockage was carried out, above all peripheral neurolysis (5).(trunc.)
Descriptors		ANALGESIA, EPIDURAL NARCOTICS PALLIATIVE CARE NEOPLASMS