Congress Abstracts 2004

70

THE ROLE OF INTRATHECAL ANALGESIA IN PALLIATIVE CARE. Karen Overmeyer, MSN, APRN, BC, and Jill Laird, MSN, APRN, Virginia Commonwealth University health Systems, Richmond, VA.

Today, even in the hands of expert pain practitioners, approximately 14% of patients with cancer suffer from intractable cancer pain. While increased opioids and adjunct medications often help, side effects from these interventions may become intolerable. Oncology nurses are in a unique position to evaluate and identify patients who require special intervention.

Recently in multicenter randomized clinical trials, we studied the use of intrathecal drug delivery systems and found this option to offer significant benefits to this population of patients. The results of this clinical trail will be reviewed discussing its implication, as well as other potential invasive techniques. The unique benefits, including statistically significant cost effectiveness, and potential complications of this analgesic technique will be explored.

A total of 202 patients with intractable pain were randomized to receive implantable drug delivery systems.

A review of selected candidates for this invasive procedure will be described to include screening tools and techniques used to ensure appropriate candidates are benefited and ongoing post-placement evaluation discussed. The main outcome measure was pain control combined with change of toxicity as measured by NCI’s common toxicity criteria.

Long-term management techniques and potential complications will be described, including problem-solving techniques. Systems issues to ensure appropriate management of patients will be reviewed. Case studies and other treatment options will be explored for candidates requiring other interventions.