• C Pederson and L Parran.
• School of Nursing, University of Minnesota, Minneapolis, USA. peder001@tc.umn.edu
• Oncol Nurs Forum. 2000 Oct 1;27(9):1371-80.

Purpose/ObjectivesTo describe current opioid-tapering practice, patient pain levels and withdrawal symptoms, and nurse documentation during opioid tapers.DesignDescriptive, exploratory, prospective, quantitative, and qualitative.SettingA 32-bed blood and marrow transplant unit in a large, tertiary U.S. care center.Sample45 blood and marrow transplant recipients between the ages of 7-64. Types of transplant were autologous, allogeneic, and unrelated donor marrow; peripheral blood stem cell; and umbilical cord blood.MethodsIn daily interviews, patients reported pain levels and withdrawal symptoms during opioid tapers. Demographic, medication, and nurse documentation data were obtained from patient hospital records.Main Research VariablesTaper length, daily opioid dosage, pain, withdrawal symptoms, and nurse documentation.FindingsLength of taper ranged from 1-17 days (X = 6.53, SD = 4.26). Analysis of variance indicated no difference by disease or transplant type in length of taper, cumulative opioids given pretaper or during taper, or number of self-reports of withdrawal symptoms. Daily changes in nurse-administered opioid dosage during tapers ranged from a decrease of 67% to an increase of 14%. Children received significantly more opioids/kg during taper than adults. Means of adults' and children's self-reports of pain were low. The means of patient-reported withdrawal symptoms were highest on taper days two through six. Nurse documentation was sparse.ConclusionsDaily taper rates vary widely, pain is well managed, and most patients experience several withdrawal symptoms.Implications For Nursing PracticeUse of an opioid-taper guideline may promote consistency of tapering while not increasing levels of pain or withdrawal symptoms.

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