Utilization of opioids for oncoicgy pain and postoperative Pain: A new england survey

s119

OF ~0F?I0~F0RclNcr)~HAINAND~~ PAIN:ANEWm SURVEY. N.M.X.A& P.F. Qnard*, v

UI’IIJ~ON

M.

Arwthesiology,

Rstmam*,

universityof -cut,

lIfpdm&

ofBsea3xh

of

inHealth~tion,

Poster 189 BLACKMon-Tues Exhibit Hall Abs No

232

Farmurgtcn, Ct. U.S.A.06032

we~~~theutilizati~ofirRraspindL~~intbeInanagementofoncolagy pain,andpostcperativepaininfi~NewEnglandstatesf~a12mmrthperiadfrom1986to mailedto the Dire&ors of Anest&siol1988.A 78% ~ratetoaauveyqoestianxaire With respectto ogy in all NewEnJlandbmpitals (258)prwidsdthe followinginfonnaticm. -logy pain, data was &tained rqardiqtheuee of intraspinalc&oids inmnnaging termir&c!ancerpain,tbernmJserof~,larrtedandex&Inal pmpsueed, numberof patients rece.ivi.rqintenni~injecti~,rn&erofpatientewitbperartaneaus vsin@arrtedcatbete=, andwb&berintraspinalc@oidswereocorsideredeffectiveinmanagirqtermindL cancerpain.~registriesin~state(~~V~)~~informationwith respecttothe~and~pfnewly~cancerf~thesametimeperiod.An vs potent-la need for spinal. qioids in the m of termindL annlymisof utilizati~ -pain

demxlstratedthatneedfarexoeededuse.

pain, we anaWith respectto the adhninistsaticpl of epiduralwioids for postaperative lyzedutilizationof the tedmip and the oawxmmitantcareprovi.dedtopatientsduring factormtbatmay influencethe tbefirst24boors [email protected]&tbe decisiontoachninisterepidurdl~~,Mmely~needto~t~ti~toanIaTora "stepclawn"unitforrespiratory~~r~,andtheaMilabilityof~monitorsor~se oxim&ermonasuryicalward.lbesunrey c&mm&rated that 13,184patientsreceivedepidufor ral opioids for pc&qerative pain. Of these, 52% receivedno special nx)nitoring respiratory-ion, 41% m mnonitored in an IUJ or a "stepdawn"unit, and 7% ware manitoredanasurgicdl~(~mcslitororpilsecorimeter).We~~thattheadministrationofepiduralnarcuti~forpos@erativepainiswidelyused, andtbeavailability of specialized nnnitoriq forrespimtiondidnot influenceutilization.

PROLONGED ANALGESIC EPIDURAL BLOCK. J.C.Branda and J.R.M.Tumbarello. Central Hospital, Mendoza, Argentina.

BLACKMon-Tues

AIM OF INVESTIGATION: Considering the analgesic limited with epldural administrationof different drugs, knowing the analgesic action of buprenorphine HCL, epidural via, for the interaction of opioids receptors and the drugs, narcotic antagonistagonist, and remembering the neuroleptics effects of the prometacine HCL, therefrom our objetive: to obtain an analgesic epidural block, unique and time ! obtalned

prolonged.

METHODS: Thirty patients, divided in: GROUP 1 (Post-operativeacute pain) and GROUP 2 [Chronic pain) received an epidural injection with buprenorphine 0.30 mg. and prometacine 50 mg.: Patients of GROUP 1, before ten minutes of the anesthesia except in the hemorrhoidectomy,in with it was realized at the end of the surgery, patients of GROUP 2: at the beginning of the treatment. RESULTS: With this methodology we obtained: Complete analgesia, no necessity of analgesics, during forty two hours (average time) and partial analgesia, with the administration of analgesics minimums dose during three hundred twelve hours (average time). The variations in arterial blood pressure, heart rate (beats/min.) hemoglobin oxygen saturation and pulse amplitude, were not significative. Undesirable effects, were not found. CONCLUSIONS: The analgesic epidural block, with buprenorphine and prometacine, gives us a prolongation of the analgesic time, with exceeds the obtained at the moment, by identic via, utilizing other drugs.