Evaluation of Acute Pain Response to Intravenous Morphine in Japanese Patients with Cancer Pain Prior to Choice of Therapy

摘要

We evaluated the effectiveness of medical therapy including intravenous morphine, lidocaine and ketamine in 100 cancer pain patients referred to our pain clinic. The site of pain overlapped in many patients including the lower back (24), upper back (17), abdomen (22), legs (18), arms (10), and shoulders (9). In 82/100 patients, the responsiveness to morphine was investigated. In 42 (51%), 23 (28%), 4 (5%) and 12 (15%) of the 82 patients, the VAS decreased by 60% or more, 30 to 60%, 15 to 30% and less than 15%, respectively. In the patients who did not respond to morphine, response to lidocaine and ketamine were investigated. Based on the response to these agents, we speculated that neuropathic pain was involved in 24/100 patients. We estimate that adequate pain relief was achieved in 96 % of our patients based on our pain management system. Introduction In the last 20 years cancer has become the most common cause of death in Japan. Despite advances in medical care during this time period the success of pain control in patients with terminal cancer is considered approximately 50%. Many factors may be responsible but an important one is that opioid treatment for the management of cancer pain, as proposed by the World Health Organization (WHO), has not been widely utilized in Japan. In this study we evaluated the effectiveness of medical therapy including intravenous morphine, lidocaine and ketamine in cancer pain patients referred to our pain clinic.