Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain

Title

Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain

Creator

Moulin DE; Kreeft JH; Murray-Parsons N; Bouquillon AI

Publisher

Lancet

Date

1991

Subject

Female; Humans; Male; Aged; Middle Aged; Severity of Illness Index; Time Factors; Double-Blind Method; Non-U.S. Gov't; Research Support; Comparative Study; Evaluation Studies; Palliative Care/methods; Infusion Pumps; Infusions; Intravenous; Hydromorphone/administration & dosage/adverse effects/blood/therapeutic use; Implantable; Neoplasms/blood/physiopathology; Pain/blood/drug therapy/etiology; Parenteral/methods

Description

To compare the safety and efficacy of subcutaneous and intravenous infusion of opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions of hydromorphone--one subcutaneously and one intravenously in randomly allocated order. The study was made double-blind by the use of two infusion pumps throughout; during the active subcutaneous infusion the intravenous pump delivered saline and vice versa. Serial measurements of pain intensity, pain relief, mood, and sedation by means of visual analogue scales showed no clinically or statistically significant difference between the two infusion routes. Side-effects were slight, and the mean number of morphine injections for breakthrough pain did not differ significantly between the routes (4.8 [SD 4.5] for intravenous vs 5.3 [5.6] for subcutaneous). Plasma hydromorphone concentrations measured at 24 h and 48 h of infusion showed stable steady-state pharmacokinetics; the mean bioavailability from subcutaneous infusion was 78% of that with intravenous infusion. Because of the simplicity, technical advantages, and cost-effectiveness of continuous subcutaneous opioid infusion into the chest wall or trunk, intravenous opioid infusion for the management of severe cancer pain should be abandoned.
1991

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

465-468

Issue

8739

Volume

337

Citation

Moulin DE; Kreeft JH; Murray-Parsons N; Bouquillon AI, “Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain,” Pediatric Palliative Care Library, accessed September 21, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12303.

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