April 1986

Patient-Controlled Analgesia for Severe Cancer Pain

Author Affiliations

From the Section of Medical Oncology, Veterans Administration Medical Center (Drs Citron, Krasnow, and Cohen and Mss Johnston-Early, Boyer, and Hood), the Department of Medicine, Georgetown University (Dr Citron), and the Department of Medicine, George Washington University (Drs Krasnow and Cohen), Washington, DC. Dr Citron is now with the Section of Medical Oncology, Long Island Jewish Medical Center, New Hyde Park, NY.

Arch Intern Med. 1986;146(4):734-736. doi:10.1001/archinte.1986.00360160162022

• Concern with the suboptimal management of pain in hospitalized patients has led to the development of a patientcontrolled analgesia system. In this system, a preset amount of narcotic is delivered intravenously when the patient activates the demand button. We tested the safety and efficacy of this mode of treatment in eight patients with cancer suffering from severe pain. Respiratory rates, mental status, and pain relief were recorded at baseline and during the study period. Morphine sulfate doses ranged from 1 to 5 mg, and lockout intervals from 15 to 90 minutes. Patients had a higher analgesic demand, le, self-administered more doses, during the first four hours than during the remaining time of treatment. Respiratory rates decreased during the first four hours of treatment, but no cases of significant respiratory depression were encountered during this period or thereafter in the study. Significant pain relief was produced in all patients without causing undue sedation. Patient acceptance of this mode of therapy was excellent, and the majority of patients preferred this type of analgesia to other forms of pain treatment. In conclusion, patient-controlled analgesic is effective and safe therapy for cancer pain.

(Arch Intern Med 1986;146:734-736)