Yonsei Med J.  2012 May;53(3):649-653. 10.3349/ymj.2012.53.3.649.

Efficacy of Epidural Analgesia in Patients with Cancer Pain: A Retrospective Observational Study

• Jeon YS
• Lee JA
• Choi JW
• Kang EG
• Jung HS
• Kim HK
• Shim BY
• Park JH
• Joo JD

• KMID: 1777003
• DOI: http://doi.org/10.3349/ymj.2012.53.3.649

Abstract

PURPOSE
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.
MATERIALS AND 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).
CONCLUSION
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.

Keyword

Bupivacaine; cancer pain; epidural analgesia; morphine

MeSH Terms

Adult
Analgesia, Epidural/*methods
Bupivacaine/therapeutic use
Female
Humans
Male
Middle Aged
Morphine/therapeutic use
Neoplasms/*physiopathology
Pain/*drug therapy
Retrospective Studies

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