Oncology
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Standard therapy for postoperative pain after laparoscopic colorectal surgeries at the Tan Tock Seng Hospital consists of intravenous morphine via patient-controlled analgesia (PCA) for the first 24-48 h, followed by oral analgesics. We compared the efficacy and safety of oral controlled-release (CR) oxycodone hydrochloride (OxyContin tablets) and PCA after laparoscopic colorectal surgeries. ⋯ Oral CR oxycodone 20 mg per day is a cheaper, convenient and an efficacious alternative analgesic to PCA opioids after laparoscopic colorectal surgery.
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To identify physician selection factors in the treatment of locally advanced head and neck cancer and how treatment outcome is affected by Tumor Board recommendations. ⋯ Disease sites remained the key determining factor for treatment selection. Multidisciplinary approaches provided optimal treatment outcome for locally advanced head and neck cancer, with overall survival in these patients being comparable to that reported in randomized clinical trials.
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Metastatic bone pain is characteristic of cancer pain. Satisfactory analgesic effects are achieved in more than 70% of patients with cancer pain who receive a combination of nonsteroidal anti-inflammatory drugs and opioids, according to the WHO therapeutic guidelines. Morphine, oxycodone, and fentanyl are commonly administered opioids. ⋯ Palliative radiation was performed in 6 patients, resulting in pain relief in 4 and therefore the dose of opioids could be reduced. Bone metastasis should not be considered as the terminal stage, and decisions on the administration of drugs, in combination with radiation or orthopedic therapy, should be made at an early stage. Alleviation of pain and allowing a better quality of patient survival time, even if not for long, should be attempted.
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Comparative Study
Controlled-release oxycodone in the treatment of neuropathic pain of nonmalignant and malignant causes.
To assess the efficacy and safety of controlled-release oxycodone in patients with moderate to severe neuropathic pain of nonmalignant and malignant causes. ⋯ The use of opioids for neuropathic pain is not fully accepted by the majority of physicians at present. This study shows that controlled-release oxycodone is a safe, well-tolerated and effective medication for neuropathic pain.
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Among all the fields of specialization in medicine, the surgeons probably encounter the highest number of pain patients, aside from 'causing' many painful conditions due to surgical procedures. It was widely presumed that surgeons in general do not pay much attention to pain management of their patients, often passing on the responsibility to other specialists. ⋯ Although the majority of the respondents claim to be involved in the management of perioperative pain of their patients, an objective assessment of the patients' pain is not usually done. The use of opioids alone or in combination is still low among Filipino surgeons; the main reason could be the regulatory provisions of the government on opioid use.