Background Pain is a common symptom that leads terminally ill patients to an emergency department. Opioids have a critical place in the management of terminal pain.
Purpose To investigate the characteristics of patients admitted for palliative care and treatments prescribed for making pain bearable and to develop query tables on the dosage and exchange of opioids.
Materials and methods The data of all the patients admitted to the hospital for palliative care from January to May 2012 (32 patients) were examined in order to study their demographics, admission date, sex, age, length of hospitalisation, reason for admission, the main disease, comorbidities, treatment used for pain and frequency of rescue from pain. Finally, we undertook a bibliographic review of the use of opioids for pain.
Results 68.7% of enrolled patients were men, with a mean age of 75.87 years overall. 75% of patients admitted had cancer, the other patients (25%) had chronic obstructive pulmonary disease. The most common comorbidities were hypertension (27%), type II diabetes (17%), heart disease (16%) and dyslipidaemia (13%). 47% of patients experienced pain during admission, which was controlled in 67% of cases with strong opioids, 27% with NSAIDs, and 6% with weak opioids. 33% of patients required rescue medicines, with an average of less than two rescues a day. Three tables were developed showing doses, exchange and opioid rescue and were distributed throughout the hospital.
Conclusions Most of the patients admitted had cancer and their pain was controlled with morphine. On average they needed fewer than two daily rescues, which could indicate that the pain was controlled. The proposed dosing and opioid exchange tables, and with the Palliative Care Unit agreement, helping to better management and safety in the administration of these drugs in the hospital.
No conflict of interest.
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