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Revista de la Sociedad Española del Dolor
Print version ISSN 1134-8046
Abstract
USARRALDE-PEREZ, A.; PEREZ-FIGUERAS, M. and VIDAL-MARCOS, A.. Use of major opioids for control of pain in hospitalized patients. Rev. Soc. Esp. Dolor [online]. 2018, vol.25, n.6, pp.318-324. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2017.3629/2017.
Objectives:
Analyze prescription characteristics of major opioids for treatment of pain in hospitalized patients, influence of the epidemiological characteristics of population, to evaluate prescription for clinical services, efficacy of the analgesia, prescription of concomitant drugs and adverse effects secondary to opioid treatment.
Material and methods:
A descriptive, retrospective study carried out between March and April 2016 at Alcorcón Foundation University Hospital. It was considered first opioid prescribed during hospital stay, being followed during first five days of treatment or until discontinuation of the same. Patients with opioid prescribing were excluded exclusively in surgical procedures, who did not continue their treatment during their admission. Variables included were sociodemographic, clinical, clinical service, prescription of major opioids and other drugs, pain assessment and adverse effects.
Results:
Most commonly prescribed opioids were morphine and fentanyl. Fentanyl and oxycodone were prescribed mainly in mixed pain, morphine in nociceptive pain and pethidine in visceral pain. Most commonly used routes of administration were intravenous and epidural. Most of the patients took other concomitant drugs, being the most frequent paracetamol. The main prescribing services were traumatology, oncology and internal medicine. Fentanyl was mainly based on traumatology and internal medicine, morphine in traumatology and oncology, oxycodone in oncology and pethidine in internal medicine. Pain unit monitored half of patients, especially in surgical patients. Majority of patients had value of the simple numerical scale, with the mean being 2.7. Side effects were mild, emphasizing nausea, vomiting and constipation.
Discussion:
Degree of analgesia obtained with opioid treatment was satisfactory, with an acceptable value. Side effects were mild, with prominent opioid nausea, vomiting and constipation. Prescription of major opioids followed the usual pattern of use in hospital setting. This type of study allows to know and compare use of opioids between clinical services and hospitals, as well as predicting needs and recognizing inefficiencies.
Keywords : Opioid analgesics; drug prescriptions; pain.