Navigation Links
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 ("systemic") drug dosage.

Based on this and other factorsincluding the patient's age, type of pain, type of cancer, and pain severity scorethe researchers were able to develop relatively simple equations for predicting the initial intrathecal opioid dose needed to control the patients' pain. The equations provided at least a guideline for estimating the initial spinal analgesia dose, while avoiding the need for an epidural trial.

In the 46 patients studied, time spent in the hospital for placement of the spinal catheter and epidural trial was between 9 and 17 days. Dr Malhotra and coauthors estimated that using the study equationsand avoiding the need for an epidural trialcould reduce hospital days by about half.

"This reduces time in the hospital for those with an already limited life expectancy and minimizes medical cost and potential complications," Dr Malhotra and coauthors write. For the patients studied, median life expectancy after leaving the hospital was less than three months.

The researchers note that their equations had a wide statistical range, indicating that they are best used for patients expected to survive only a short time. But for these patients, the study equation will provide a useful starting point, allowing patients to spend more of their final days at home rather than in the hospital. Dr Mahtola and colleagues plan further researchincluding data on side effects and quality of lifeto refine their equations and better evaluate the benefits of intrathecal analgesia for intractable cancer pain.


'/>"/>

Contact: Nancy Lynly
nlynly@iars.org
415-296-6907
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. As Summer Approaches, Experts Offer Tips on Preventing Skin Cancer
2. New screening approach uncovers potential alternative drug therapies for neuroblastoma
3. New Approach to ADHD Managment Focuses On Parents, Not Kids
4. Research offers promising new approach to treatment of lung cancer
5. New vRating™ Video and Unified Communications Scoring System Delivers Innovative Approach to Measure Performance and ROI for Collaboration Networks
6. Green Acre Aquaponics Introduces a Revolutionary Approach to Farm Education and Commercial Aquaponics
7. Study identifies new approach to improving treatment for MS and other conditions
8. ‘Get Your Lean On’ Gives Readers New Approach to Weight Loss
9. Beyond Rules—Sean A. Anderson’s Remarkable 275 Pound Weight-Loss Approach Now on Paperback and E-book
10. Atlantic Spine Center Announces Updated Web Content on Spinal Stenosis New Treatments and a Better Approach to Spinal Stenosis Surgery
11. New approaches in treating complicated childhood polycystic kidney disease
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/29/2017)... ... May 29, 2017 , ... Commercial door hardware needs ... businesses don’t just need to protect the lives of people such as employees, ... information, physical inventory, assets and company records too. Further, businesses aren’t just protecting ...
(Date:5/29/2017)... ... May 29, 2017 , ... The quest to develop a cure for ... if someone is cured? The virus has a knack for lying dormant in immune ... Scientists at the University of Pittsburgh’s Graduate School of Public Health announced today in ...
(Date:5/28/2017)... ... May 28, 2017 , ... Florida Pain Relief Group, a ... Fernandez-Silva, M.D., has joined its new Melbourne pain clinic. , Dr. Fernandez-Silva’s ... invasive techniques to treat and manage many types of pain. , Dr. ...
(Date:5/27/2017)... California (PRWEB) , ... May 26, 2017 , ... A ... citizens who visit a doctor for colds or respiratory issues that are not responsive ... excessive time pressure on doctors may be largely responsible for the problem both in ...
(Date:5/27/2017)... ... ... From May 21-23, hearing healthcare professionals gained a competitive edge with training from ... Downtown Hotel in Syracuse, New York. , As EarQ’s technology partner, Oticon hosts ... help them stay ahead in the industry. At the event, EarQ members learned about ...
Breaking Medicine News(10 mins):
(Date:5/10/2017)... 10, 2017 Radiology has become the number ... have also spiraled to the number one ranking as ... than ever before as the most complete and reliable ... with lower back pain an MRI may confirm a ... pain, resulting in entirely different treatment protocols.  In these ...
(Date:5/9/2017)...  Oramed Pharmaceuticals Inc. (NASDAQ: ORMP ... focused on the development of oral drug delivery ... Office has granted Oramed a patent titled, "Methods ... patent covers Oramed,s invention of an oral glucagon-like ... incretin hormone that stimulates the secretion of insulin ...
(Date:5/6/2017)... , May 5, 2017   Provista , a proven ... than 200,000 customers, today announced Jim Cunniff as ... of executive and business experience to Provista, including most recently ... in California . He assumed his new ... is a great fit for Provista," says Jody Hatcher ...
Breaking Medicine Technology: