Document Detail


Epidural methadone results in dose-dependent analgesia in cancer pain, further enhanced by epidural dexamethasone.
MedLine Citation:
PMID:  23322191     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study was designed to evaluate the role of epidural methadone-lidocaine in cancer pain combined or not to epidural dexamethasone.
METHODS: In all, 72 cancer patients, 32- to 67-year-old were randomized to six groups (n=12) and prospectively studied to examine analgesia and adverse effects for 3 weeks. Patients received single-dose protocol epidural test drugs: Control group (CG) received epidural 40-mg lidocaine diluted to 10-ml volume with saline. Dexamethasone group (DG) 40-mg lidocaine plus 10-mg dexamethasone. The 2.5MetG 2.5-mg epidural methadone with 40-mg lidocaine; the 5MetG, 5-mg epidural methadone plus 40-mg lidocaine, the 7.5MetG, 7.5-mg epidural methadone plus 40-mg lidocaine and finally the 7.5Met-DexG, 7.5-mg methadone with 40-mg lidocaine and 10-mg dexamethasone.Results:Groups CG, DG and 2.5MetG were similar regarding analgesia and side effects. Patients from 5MetG and 7.5MetG took 3 ± 1 and 5 ± 1 days, respectively, to restart oral morphine. Patients from 7.5MetDG took 14 ± 2 to restart oral morphine (P<0.001). Daily somnolence and appetite improved in the 7.5MetDG during 2-week evaluation (P<0.005). Fatigue improved for both DG and 7.5MetDG during 2-week evaluation (P<0.005). By the third week of evaluation, all patients were similar.
CONCLUSIONS: Epidural methadone plus lidocaine resulted in dose-dependent analgesia, further improved by epidural dexamethasone, which also improved fatigue.
Authors:
G R Lauretti; C C Rizzo; A L Mattos; S W Rodrigues
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-01-15
Journal Detail:
Title:  British journal of cancer     Volume:  108     ISSN:  1532-1827     ISO Abbreviation:  Br. J. Cancer     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-06     Completed Date:  2013-04-02     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  0370635     Medline TA:  Br J Cancer     Country:  England    
Other Details:
Languages:  eng     Pagination:  259-64     Citation Subset:  IM    
Affiliation:
Teaching Hospital, Department of Biomechanics, Medicine and Rehabilitation of Members of the Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto-São Paulo 14039 900, Brazil. grlauret@fmrp.usp.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesia, Epidural*
Dexamethasone / administration & dosage*,  adverse effects,  therapeutic use
Drug Administration Routes
Female
Humans
Lidocaine / administration & dosage,  adverse effects,  therapeutic use
Male
Methadone / administration & dosage*,  adverse effects,  therapeutic use
Middle Aged
Neoplasms / physiopathology*
Pain / drug therapy*
Pain Management
Chemical
Reg. No./Substance:
137-58-6/Lidocaine; 50-02-2/Dexamethasone; 76-99-3/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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