Subcutaneous and intravenous administration of analgesics in palliative medicine

Jolanta Życzkowska; Jerzy Wordliczek

Vol 8, No 4 (2009)

Review articles

Published online: 2010-02-01

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Subcutaneous and intravenous administration of analgesics in palliative medicine

Jolanta Życzkowska, Jerzy Wordliczek

Advances in Palliative Medicine 2009;8(4):153-160.

Vol 8, No 4 (2009)

Review articles

Published online: 2010-02-01

Abstract

Pain is one of the most frequent complaints reported by cancer patients. In their terminal periods, the proportion of patients suffering from pain reaches 75%. Even, the most convenient route of administration of medicines is the oral route, not every clinical situation permits the oral therapy. Alternative routes of administration of medicines, especially in palliative medicine, involve multiple injections or continuous infusions, both subcutaneous and intravenous. Most opioids (morphine, diamorphine in small doses, oxycodon, pethidine, fentanyl, tramadol) can be administered subcutaneously. There are no significant differences between the subcutaneous and intravenous (i.v.) application of medicines in terms of their absorption, efficacy and the frequency of side effects. The titration of i.v. opioids is not only an effective and rapid method of pain relief, but also is safe and unrelated to increased risk of respiratory centre depression. The role of intravenous administration of medicines increase especially at the terminal stages of cancer patients’ life. An appropriate choice of administration route or its exchange to an alternative one may in a number of cases improve the comfort and quality of life of patients receiving palliative care.