Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain

摘要: To compare the safety and efficacy of subcutaneous intravenous infusion opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions hydromorphone--one subcutaneously one intravenously randomly allocated order. The study made double-blind by use pumps throughout; during active pump delivered saline vice versa. Serial measurements intensity, relief, mood, sedation means visual analogue scales showed no clinically or statistically significant difference between routes. Side-effects were slight, mean number morphine injections for breakthrough did not differ significantly routes (4.8 [SD 4.5] vs 5.3 [5.6] subcutaneous). Plasma hydromorphone concentrations measured at 24 stable steady-state pharmacokinetics; bioavailability from 78% that infusion. Because simplicity, technical advantages, cost-effectiveness continuous into chest wall trunk, management should be abandoned.