TOLERANCE AND EFFECTIVENESS OF OXYCODONE IN PATIENTS WITH MIXED LUMBAR PATHOLOGY PRESENTING INTOLERANCE TO OTHER OPIATES


Cía P, Quero JC, Rodrigo MD . ( Hospital Clínico Universitario “Lozano Blesa” Zaragoza SPAIN )
Presentado en Estambul, en el 5º Congress of the European Federaton of IASP (Estambul septiembre 13-16,2006)


Analyse the tolerance and effectiveness of oxycodone in patients with lumbar pain irradiated in limbs (pain with nociceptive and neuropathic components) who have showed intolerance to other opiate drugs.

METHODS AND MATERIALS 12 patients have been chosen. They have a clinical history of lumbalgia irradiated in limbs with mixed component and they are under treatment of maximum doses of anticonvulsive drugs. All of them have shown intolerance to two or more opiates, and because of the persistence of high intensity pain according to visual analogic scale (VAS), a treatment with oxycodone was started. Pain level was defined by patients as intense according to Latinen scale. VAS evaluation showed important individual differences throughout the day according to the patient's activity. Thus, all the patients showed a maximum VAS equal or higher to 8 (average 8.91±0.79) and a minimum VAS of 6 or lower (average 4.25±1.81) before starting the treatment with oxycodone. 8 patients had shown intolerance to transdermal Buprenorphine, 7 to tramadol, 5 to transderaml fentanyl and 2 showed intolerance to oral morphine.

RESULTS 2 of the 12 patients showed oxycodone side effects and had to quit the treatment. For the 10 patients that continued, doses were adapted according to circumstances and effects in each patient. Average dose of oxycodone in this group of patients has been 45 mg per day. After the establishing of the treatment VAS maximum average decreased to 5.4(±1.26) and the minimum VAS average decreased to 2.8 (±1.47)

Patient 1 2 3 4 5 6 7 8 9 10 11 12
Age 67 53 46 68 58 57 46 34 57 59 63 56
Weight(kilograms) 70 51 80 72 74 86 70 98 84 65 80 78
Max VAS 8 9 8 8 10 9 9 10 8 9 10 9
Min VAS 3 5 2 3 5 1 6 3 5 7 5 6
Max VAS(oxycodone) 5 7 4 6 - 6 5 5 7 3 6 -
Min VAS(oxycodone) 3 4 2 3 - 0 4 3 5 1 3 -
Tramadol intolerance Yes No No Yes Yes Yes No No Yes No Yes Yes
Buprenorphine intol. Yes No Yes Yes Yes Yes No Yes Yes No Yes No
Oral Morphine intol. No Yes No No No No Yes No No No No No
Fentanyl intolerance No No Yes No No No Yes Yes No Yes No Yes
Dose/day(oxycodone) 40 60 40 80 20 80 40 40 80 80 80 20
Side effects No No No No Yes No No No No No No Yes

CONCLUSION The oxycodone has happened to be an opiate generally tolerated by a group of patients with a history of intolerance to other opiates. Only 2 of the patients of the group (16.66%) did not tolerate oxycodone. Regarding the effectiveness, oxycodone has managed to lower the maximum and minimum VAS in every case. In the maximum VAS, there has been a change from 8.91(±0.79) to 5.4(±1.26) after the treatment with oxycodone. In the minimum VAS, there has been a change from a change from 4.25(±1.81) to 2.8(±1.47) after the treatment.

 

Ir a la parte superior de la página | Ir al indice de publicacionesl

 

 
 
Creado por cycvision