| Budget Amount *help |
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 2006: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 2005: ¥1,700,000 (Direct Cost: ¥1,700,000)
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| Research Abstract |
Background: Adjuvant analgesics are described as the drugs used as analgesics which are not usually used as painkiller but have analgesic effect on special pain (e.g. neuropathic pain). Approximately 30% of patients with cancer suffer from neuropathic pain, which contributes largely to the treatment difficulties Additionally, use of opioid analgesics based on degree of pain appears to be effective in over 80% cases with cancer pain. However, in approximately 5% of patients, it seems that the dose of opioids cannot be increased based on degree of pain because of the adverse effects such as drowsiness, nausea and constipation. Previous studies have reported the synergistic or additive effect of opioid and adjuvant analgesics on neuropathic pain, but enhancing effect of adjuvant analgesics on opioid analgesia in normal somatic pain has not been reported.
Objective and Methods The objective of this study is to investigate whether the dose of opioid can be reduced in opioid-effective somatic pain by concomitant use of adjuvant analgesics (NMDA receptor antagonists, antidepressants, anticonvulsants and other drugs).
Results: There were several situations which cause change in the list of target drugs, ketamine was unexpectedly designated as narcotic drug and use of gabapentin as anticonvulsant agent was approved during the study period. Therefore, the number of cases for each drug was few and statistical analysis was impossible at that time. However, considerable number of patients showed opioid-reducing effect of adjuvant analgesics. We considered that this result provided basis on further investigation.
Discussion: This study found the possibility that the addition of adjuvant analgesics, as well as changing the type of opioid, may improve insufficient pain management when it is difficult due to untreatable adverse effects of opioid like opioid-intolerance. Also, this study was valuable from the viewpoint of contribution to the palliative care practice in cancer.
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