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New approach may allow faster spinal anesthesia for cancer patients at end of life
Date:5/27/2013

San Francisco, CA. (May 28, 2013) For patients with uncontrolled pain from terminal cancer, a new approach to calculating initial dosage may allow a quicker start of spinal analgesiaand less time in the hospital, according to a study in the June issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Led by Dr Vivek Tim Malhotra of Memorial Sloan Kettering Cancer Center, New York, the researchers developed a set of equations for estimating the initial dose of intrathecal spinal pain relievers, thus avoiding the need for a trial period of epidural anesthesia in the hospital. The researchers hope their method will shorten the time to satisfactory pain control in patients with pain from advanced cancer, allowing them to spend more of their remaining days at home.

New Equations for Estimating Intrathecal Analgesia Dose

Intrathecal analgesia is an important option for "intractable" cancer pain that no longer responds to oral or injected pain medications. In this technique, a catheter is placed in the intrathecal space around the spinal cord, with individualized doses of strong opioid pain relievers given through a drug pump. The standard approach to determining the initial dose is a trial period of another type of spinal drug injectionepidural analgesiaperformed in the hospital.

However, by the time patients are referred to a pain specialist for spinal analgesia, they typically have advanced cancer with limited life expectancy. Dr Malhotra and colleagues were looking for some way of calculating the initial intrathecal analgesia dose without the need for an epidural trial.

The researchers performed an in-depth analysis of 46 patients, treated over a six-year period, who underwent an epidural drug trial before intrathecal analgesia. The goal was to develop a way of predicting the initial intrathecal dose based on the patient's last oral or injected ("systemi
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Contact: Nancy Lynly
nlynly@iars.org
415-296-6907
Wolters Kluwer Health
Source:Eurekalert

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