Treatment of pain in chronic bowel subobstruction with self-administration of methadone

Chronic treatment with opioids in cancer patients with chronic intestinal obstruction is hazardous, as uncontrolled constipation may result in definitive bowel obstruction. Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opioid doses that will...

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Bibliographic Details
Published in:Supportive care in cancer 1997-07, Vol.5 (4), p.327-329
Main Authors: MERCADANTE, S, SAPIO, M, SERRETTA, R
Format: Article
Language:English
Subjects:
Adult
Analgesia, Patient-Controlled
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Biological and medical sciences
Breast Neoplasms - complications
Chronic Disease
Fatal Outcome
Female
Humans
Hypnotics. Sedatives
Intestinal Obstruction - chemically induced
Intestinal Obstruction - prevention & control
Medical research
Medical sciences
Methadone - administration & dosage
Methadone - adverse effects
Middle Aged
Neuropharmacology
Ovarian Neoplasms - complications
Pain
Pain, Intractable - drug therapy
Pharmacology. Drug treatments
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Citations: Items that cite this one
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Description
Summary:Chronic treatment with opioids in cancer patients with chronic intestinal obstruction is hazardous, as uncontrolled constipation may result in definitive bowel obstruction. Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opioid doses that will have sufficient effect, with a consequently lower risk of intestinal side effects. Methadone has many pharmacokinetic characteristics that fit it for use in this clinical situation. In two patients with recurrent episodes of bowel obstruction, methadone used at low doses and at flexible intervals regulated by the patients according to their pain level avoided the occurrence of new episodes of intestinal obstruction. Oral patient-controlled analgesia with methadone may be a simple, safe and cheap method of treating patients with pain associated with subtotal intestinal obstruction.
ISSN:0941-4355
1433-7339
DOI:10.1007/s005200050082