Vol 13, No 1 (2019)
Research paper
Published online: 2019-04-04

open access

Page views 779
Article views/downloads 857
Get Citation

Connect on Social Media

Connect on Social Media

The use of opioid analgesics in chronic pain therapy — a retrospective, single-center study

Piotr Jakubów12, Anna Maria Łotowska- Ćwiklewska3, Urszula Kościuczuk31
Palliat Med Pract 2019;13(1):11-16.

Abstract

Introduction: The use of opioids is fundamental in moderate and severe pain management. There is an
increase in opioids use in highly developed countries, while at the same time in other countries, difficulties
in access to appropriate pain treatment are observed. The aim of the study was to determine the use of
opioids in the treatment of chronic cancer-related and non-cancer pain.
Material and methods: The study covered the medical documentation of patients under the care of the
Pain Medicine Clinic, Palliative Medicine Clinic and Hospice in the period 01.01.2017–30.04.2017 which
reported: sex, age, duration of medical services, primary diagnosis, opioid treatment — pharmacological
substances, a form of supply and side effects.
Results: In the study, 634 medical consultations of 196 patients were analyzed and 32 (16%) of them were
cancer patients. The predominant cause of pain were degenerative diseases, disorders of the spinal nerves
and nerve plexuses. Oxycodone was most often used as a monotherapy for cancer and non-cancer pain.
Transdermal buprenorphine was significantly more frequently used in non-cancer pain and transdermal
fentanyl was more frequently administered in cancer-related pain. In the group of cancer patients, the
principles of multi–modal therapy were more often applied and no adverse effects were noted.
Conclusions: Opioids are the primary method in pharmacotherapy at the specialist level. Oxycodone is
widely used in monotherapy of cancer-related and non-cancer pain. Various forms of the supply of opioids
in the therapy of chronic cancer pain is not associated with the risk of side effects.
Palliat Med Pract 2019; 13, 1: 11–16

Article available in PDF format

View PDF Download PDF file

References

  1. Manchikanti L, Kaye AM, Knezevic NN, et al. Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Pain Physician. 2017; 20(2S): S3–S92.
  2. Wordliczek J, Kotlińska–Lemieszek A, Leppert W, et al. Farmakoterapia bólu u chorych na nowotwory – zalecenia Polskiego Towarzystwa Badania u, Polskiego Towarzystwa Medycyny Paliatywnej, Polskiego Towarzystwa Onkologicznego, Polskiego Towarzystwa Medycyny Rodzinnej, Polskiego Towarzystwa Anestezjologii i Intensywnej terapii. Ból. 2017; 18: 11–53.
  3. Ciałkowska-Rysz A, Dzierżanowski T. Podstawowe zasady farmakoterapii bólu u chorych na nowotwory i inne przewlekłe, postępujące, zagrażające życiu choroby. Med Paliat. 2014; 6: 1–6.
  4. Misiołek H, Mayzner–Zawadzka E, Dobrogowski J, et al. Zalecenia 2011- postępowanie w bólu ostrym i pooperacyjnym. Ból. 2011; 12: 1–26.
  5. Jakubów P, Kosel J, Kościuczuk U, et al. Leczenie bólu nienowotworowego buprenorfiną. Med Paliat. 2016; 8: 80–87.
  6. Ashaye T, Hounsome N, Carnes D, et al. COPERS Study Team (ISRCTN 24426731).. Opioid prescribing for chronic musculoskeletal pain in UK primary care: results from a cohort analysis of the COPERS trial. BMJ Open. 2018; 8(6): e019491.
  7. Dzierżanowski T, Ciałkowska-Rysz A. Accessibility of opioid analgesics and barriers to optimal chronic pain treatment in Poland in 2000-2015. Support Care Cancer. 2017; 25(3): 775–781.
  8. Von Korff MR. Long-term use of opioids for complex chronic pain. Best Pract Res Clin Rheumatol. 2013; 27(5): 663–672.
  9. Khoury M, Caspi S, Stalnikowics R, et al. Emergency Department Administration of Oxycodone by Nurses Treating Musculoskeletal Pain: An Observational Prospective. Isr Med Assoc J. 2018; 5(20): 281–285.
  10. Dobrogowski J, Przeklasa–Muszyńska A, Woroń J, et al. Zasady kojarzenia leków w terapii bólu. Med Paliat Prakt. 2007; 1: 6–15.
  11. Woroń J, Engel Z. Skojarzona farmakoterapia bólu, czyli o zasadach racjonalnej politerapii bólu. Anestezjol Ratow. 2012; 6: 89–93.
  12. Dobrogowski J. Wordliczek J. Przeklasa–Muszyńska A. Zastosowanie silnie działających opioidów w leczeniu bólu nienowotworowego. Med Paliat Prakt. 2007; 1: 43–48.
  13. Leppert W. Postępy w leczeniu farmakologicznym bólu nowotworowego analgetykami opioidowymi. Współcz Onkol. 2009; 13: 66–73.
  14. Modlińska A. Zaparcia indukowane opioidami w bólu przewlekłym- praktyczne aspekty zastosowania oksykodonu z naloksonem. Med Paliat Prakt. 2013; 7: 1–5.
  15. Jakubów P, Kościuczuk U, Kosel J. Ocena zastosowania tapentadolu w uporczywym bólu pochodzenia neuropatycznego w bólu nowotworowym. Med Paliat. 2017; 9: 225–230.
  16. Mumba MN, Findlay LJ, Snow DE. Treatment Options for Opioid Use Disorders: A Review of the Relevant Literature. J Addict Nurs. 2018; 29(3): 221–225.
  17. Dzierżanowski T. Ciałkowska–Rysz A. Tapentadol w leczeniu przewlekłego bólu związanego z nowotworem. Med Paliat. 2016; 8: 157–163.
  18. Hartrick CT, Rozek RJ. Tapentadol in pain management: a μ-opioid receptor agonist and noradrenaline reuptake inhibitor. CNS Drugs. 2011; 25(5): 359–370.
  19. Mercadante S. The role of tapentadol as a strong opioid in cancer pain management: a systematic and critical review. Curr Med Res Opin. 2017; 33(11): 1965–1969.
  20. Garland EL, Froeliger B, Zeidan F, et al. The downward spiral of chronic pain, prescription opioid misuse, and addiction: cognitive, affective, and neuropsychopharmacologic pathways. Neurosci Biobehav Rev. 2013; 37(10 Pt 2): 2597–2607.
  21. Leppert W, Forycka M, Nosek K. Ból przebijający i epizodyczny u chorych na nowotwory. Med Paliat. 2016; 8: 9–16.
  22. Trescot AM, Helm S, Hansen H, et al. Opioids in the management of chronic non-cancer pain: an update of American Society of the Interventional Pain Physicians' (ASIPP) Guidelines. Pain Physician. 2008; 11(2 Suppl): S5–S62.