Continuous Narcotic Infusion with Patient-Controlled Analgesia for Chronic Cancer Pain in Outpatients

Abstract

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.