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American Society for Action on Pain

UI - 000056

AU - Baumann TJ

AU - Batenhorst RL

AU - Graves DA

AU - Foster TS

AU - Bennett RL

TI - Patient-controlled analgesia in the terminally ill cancer patient

AB - Patient-controlled analgesia (PCA) is a relatively new therapeutic modality which has allowed

postsurgical patients to safely and effectively self-administer doses of intravenous narcotics via a syringe

pump and sequencing device. A pilot study was designed to evaluate PCA's safety and effectiveness in the

terminally ill cancer patient. Eight patients whose chronic pain was not adequately controlled by oral

narcotics were permitted to use PCA for a minimum of 48 hours. Respiratory rates, sedation rankings, and

pain rankings indicated these patients achieved satisfactory analgesia with a minimum of sedation and

experienced no respiratory depression. Three patients were switched to oral regimens using PCA dosing as a

guide. Pain and sedation rankings were similar to those registered while exclusively on PCA. This self-

dosing technique was judged to be safe, effective, and able to accommodate wide fluctuations in analgesic

need when treating pain in the terminally ill cancer patient. The results obtained in these patients support

further trials using PCA to individualize oral analgesic regimens

SO - Drug Intelligence & Clinical Pharmacy 1986;20:297-301