Analgesia and serum assays of controlled-release dihydrocodeine and metabolites in cancer patients with pain.
نویسندگان
چکیده
Aim of the study was to assess dihydrocodeine (DHC) and metabolites concentrations and their correlations with DHC analgesia in cancer patients with pain. Thirty opioid-naive patients with nociceptive pain intensity assessed by VAS (visual analogue scale) > 40 received controlled-release DHC as the first (15 patients, 7 days) or as the second opioid (15 patients, 7 days). Blood samples were taken on day 2, 4 and 7 at each study period. DHC and its metabolites were assayed by HPLC. DHC provided satisfactory analgesia when administered as the first or the second opioid superior to that of tramadol. When DHC was the first opioid administered, DHC and dihydrocodeine-6-glucuronide (DHC-6-G) concentrations increased in the second and the third comparing to the first assay. A trend of nordihydromorphine (NDHM) level fall between the first and the third assay was noted; trends of dihydromorphine (DHM) level increase in the second relative to the first determination and decrease in the third compared to the second assay were observed. When DHC followed tramadol treatment a trend of DHC concentration increase in the second relative to the first assay was noted. DHC-6-G level increased in the second and in the third comparing to the first determination; NDHM and DHM concentrations were stable. DHC and DHC-6-G concentrations increased similarly during both treatment periods which suggest their prominent role in DHC analgesia. Few significant correlations were found between DHC dose, DHC and metabolites serum concentrations with analgesia suggesting the individual DHC dose titration.
منابع مشابه
Role of oxycodone and oxycodone/naloxone in cancer pain management.
Oxycodone is a valued opioid analgesic, which may be administered either as the first strong opioid or when other strong opioids are ineffective. In case of insufficient analgesia and/or intense adverse effects such as sedation, hallucinations and nausea/vomiting a switch from another opioid to oxycodone might be beneficial. Oxycodone is administered to opioid-naive patients with severe pain an...
متن کاملPatient controlled analgesia versus conventional analgesia for postoperative pain
Purpose: Patients may control postoperative pain by self-administration of intravenous opioids using devices designed for this purpose (patient controlled analgesia or PCA). This study set out to determine whether any of the two opioid administrations (i.e. PCA or conventional analgesia) would provide superior pain relief among patients undergoing laparoscopic cholecystectomy or not. ...
متن کاملPatient controlled analgesia versus conventional analgesia for postoperative pain
Purpose: Patients may control postoperative pain by self-administration of intravenous opioids using devices designed for this purpose (patient controlled analgesia or PCA). This study set out to determine whether any of the two opioid administrations (i.e. PCA or conventional analgesia) would provide superior pain relief among patients undergoing laparoscopic cholecystectomy or not. ...
متن کاملMultimodal Pain Management Protocol Versus Patient Controlled Narcotic Analgesia for Postoperative Pain Control after Shoulder Arthroplasty
Background: Our institution’s traditional pain management strategy after shoulder arthroplasty has involved the utilization of postoperative patient-controlled narcotic analgesia. More recently, we have implemented a protocol (TLC) that utilizes a multimodal approach. The purpose of this study was to determine whether this change has improved pain control and decreased narcotic utilization. ...
متن کاملEffect of patient education about patient-controlled analgesia pump before surgery on severity of pain, nasia and vomiting after Spinal culumn surgery
Objective: Therefore, the present study was conducted to determine the Effect of patient education about patient-controlled analgesia pump before surgery on severity of pain, nausea and vomiting after Spinal column surgery. Material and Methods: The present study was a randomized controlled clinical trial. Sixty patients that were in the spinal column surgery list, selected by accessible metho...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Pharmacological reports : PR
دوره 64 1 شماره
صفحات -
تاریخ انتشار 2012