Journal
SUPPORTIVE CARE IN CANCER
Volume 29, Issue 12, Pages 7611-7616Publisher
SPRINGER
DOI: 10.1007/s00520-021-06350-2
Keywords
Refractory cancer pain; Gabapentin; Morphine; IDDS
Funding
- Harbin Scientific Technology Bureau [2016RAQXJ213]
- Heilongjiang Postdoctoral Research Developmental Funding [LBH-Q14214]
Ask authors/readers for more resources
The study aimed to determine the analgesic efficacy and safety of combining gabapentin with morphine after IDDS implantation. The combination therapy achieved similar analgesic efficacy with lower dose of morphine compared to morphine alone, but had a higher incidence of dizziness and somnolence.
Purpose Morphine infusion through Intrathecal Drug Delivery System (IDDS) is widely used to relieve refractory cancer pain. However, continuous escalation of morphine dose caused by opioid tolerance and/or progress of cancer was commonly observed. Combining morphine with medications of different analgesic mechanisms is applied to blunt the rate of morphine increase. The purpose of this study was to determine the analgesic efficacy and safety of combining gabapentin with morphine after IDDS implantation. Methods This study compared patients that received IDDS implantation from January 1, 2017 to November 10, 2018 in our institute. Key outcomes included change in mean pain score, dose of morphine used in patients, percentage of patients with 30% and 50% reduction in mean pain score, Patient Global Impression of Change scores, breakthrough pain characters and side effects. Results 34 patients in the combination group (morphine + gabapentin) and 40 patients in the monotherapy group(morphine) were analyzed. The results showed that both therapy groups achieved similar analgesic efficacy, demonstrated by Numerical rating scale (2.42 +/- 0.88 vs 2.57 +/- 0.85; Combination vs Monotherapy), PGIC and responder status. Mean daily dose of morphine was significantly lower in combination group compared to monotherapy group (3.54 +/- 1.29 mg vs 4.64 +/- 1.28 mg, P=0.007). More patients experienced dizziness and somnolence after receiving combination therapy compared to morphine-alone treatment although no statistical significance was found (P=0.49). Conclusion Addition of gabapentin achieved similar analgesic efficacy with lower dose of morphine compared to morphine alone accompanying with higher incidence of dizziness and somnolence.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available