Pain Control Center Hospice, Solofra, Italy
Geppino Genua, Luisa M Rizzo, Mela Fasano, P. Lino Fina, Elena De Vinco, A. M. Strollo, Sergio Canzanella, S. Florio, Vincenzo Landolfi
Background: We have evaluated the treatment procedures and the clinical outcome in terms of pain control on 163 consecutive patients enrolled from December 2012 to April 2014 at “Pain Control Center” of the Hospice of Solofra. Methods: The following characteristics have been evaluated: patient gender, mean hospitalization time, differentiation between cancer and non cancer patients (pt.), tumour type, medical weapon use, venous access type, parenteral feeding, transfer in intensive care units, pain killer use. Results: Of the 163 patients (96 males and 67 females, mean age 63.31 years, range: 31-90 years, mean hospitalization time: 29.85 days) 126/163 pt (77.30%) had tumour diseases and 37/163 pt. (22.69%) non cancer diseases. Cancer pt. had lung (24.6%), colo-rectal (17.46%), breast (4.76%), bladder (5.55%), gastric (5.55%), prostate (3.17), hepatocellular (4.76%), pancreas (3.96%), head and neck (4.76%), kidney (3.17%) and other site tumours (19.67%). Patients with tracheostomy were 14/163 (8.58%), with gastrostomy 11/163 (6.74%), with uretero and colostomy 21/163 (12.88%) and with active mechanical ventilator 5/163 (3.06%). The central venous accesses were already present at the moment of the hospitalization in 61/163 pt. (37.42%); during the hospitalization the central venous access were made on 48/163 (29.44%). Seventy-six out of 163 pt. (46.62%) received either total or partial parenteral feeding while 26/163 pt. (15.95%) received enteral feeding. Analgesic therapy with opioids was administered at 131/163 pt. (80.36%) as it follows: morphin in 18.32%; oxycodon/naloxon in 23.63%; codein-paracetamol in 9.16% and transdermic or transmucosal Fentanyl in 48.85% of the pt. The most intensively treated pts. were those with tracheostomy followed by uretero and colostomy. Conclusions: The results of the present study confirm the underestimation of the parenteral feeding and analgesic requirements by pts. with chronic diseases. Another interesting result of the present report is the good clinical benefit achieved with the use of oxycodon/naloxon associated or not with other pain killers. These results are on line with the guidelines that suggest the use of oral slow release opioids.
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