| Epidural methadone results in dose-dependent analgesia in cancer pain, further enhanced by epidural dexamethasone. | |
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MedLine Citation:
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PMID: 23322191 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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G R Lauretti; C C Rizzo; A L Mattos; S W Rodrigues |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2013-01-15 |
Journal Detail:
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Title: British journal of cancer Volume: 108 ISSN: 1532-1827 ISO Abbreviation: Br. J. Cancer Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-02-06 Completed Date: 2013-04-02 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0370635 Medline TA: Br J Cancer Country: England |
Other Details:
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Languages: eng Pagination: 259-64 Citation Subset: IM |
Affiliation:
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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:
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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:
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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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