Clin J Pain. 2021 Jul 9. doi: 10.1097/AJP.0000000000000959. Online ahead of print.
ABSTRACT
CONTEXT AND OBJECTIVES: Although opioids play an indispensable role in the management of cancer-related pain, inadequate pain relief still occurs. The primary objective of this study was to evaluate whether the combination of a low dose of methadone with morphine promotes a reduction in opioid consumption; the secondary objectives were if the association promotes lower pain intensity, and adverse effects.
METHODS: There were studied 41 patients with cancer-related pain in palliative setting. They were starting the third step of the analgesic ladder, and one group achieve methadone (2.5▒mg/12▒h) in combination with morphine (MM), and another group received morphine (M) alone. Both groups could use morphine (5▒mg) as needed to maintain pain intensity <4, and adjuvant in stable dose. The following outcomes were evaluated: total morphine dose, pain intensity, and adverse effects.
RESULTS: There was no difference in the number of adjuvants, and the dose of morphine used. Pain intensity was lower in the MM group after 2 weeks, with no statistically significant difference at other time points. There was no difference in the adverse effects.
CONCLUSIONS: Low dose of methadone in combination with morphine provided faster pain control as compared to morphine alone, and although this study was not powered to show differences in adverse effects, we did not notice a difference.
PMID:34265791 | DOI:10.1097/AJP.0000000000000959
