Continuous narcotic infusion with patient-controlled analgesia for chronic cancer pain in outpatients.

STUDY OBJECTIVE

To determine the feasibility and safety of outpatient continuous narcotic infusions with additional bolus capabilities (patient-controlled analgesia) in patients with cancer pain.

DESIGN

A single arm (non-randomized) series.

SETTING

Outpatient with contact by telephone and through outpatient clinic.

PATIENTS

Consecutive series of 18 patients with poorly controlled cancer pain or significant side effects from regular administration of various narcotics.

INTERVENTIONS

Patients taught and supervised to use portable pump capable of delivering a continuous narcotic infusion with bolus capabilities.

MEASUREMENTS AND MAIN RESULTS

All patients had improvement in pain control as judged by the use of a linear analogue scale. Side effects and safety profile were highly acceptable. Narcotics used and maximum doses were meperidine, 50 mg/h; morphine, 80 mg/hr; and hydromorphone, 60 mg/hr. Infusion duration ranged from 7 to 225 days (mean, 54 days).

CONCLUSIONS

Continuous narcotic infusions using a programmable portable pump with bolus capabilities is a safe and reliable method of delivering narcotics to outpatients.