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Management of Neuropathic Cancer Pain Following WHO Analgesic Ladder: A Prospective Study

Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, mseema17{at}yahoo.co.in

Sushma Bhatnagar, MD

Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Deepak Gupta, MD

Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Gaurav Nirwani Goyal, MD

Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Roopesh Jain, MD

Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Himanshu Chauhan, MD

Unit of Anesthesiology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Cancer pain treatment according to the guidelines of World Health Organization (WHO) is effective and safe in majority of patients. 818 neuropathic cancer pain patients were enrolled in the study and pain was managed according to WHO analgesic ladder and followed up to six months. Main adjuvant drugs used were amitryptaline (29.9%), gabapentin (29.9%) and gabapentine with dexamethasone in (19.9%) and dexamethasone alone in (20.2%) patients. Opioids prescribed were mainly tramadol, codeine sulphate and morphine. 52% patients received morphine as rescue analgesic. At the end of six months 53.2% patients had no pain and 41.9% of patients had mild pain as compared to 0% and 10.2% patients respectively at the first visit. 4.9% of patients had moderate pain even after the treatment. Neuropathic cancer pain can be relieved by multimodal treatment following WHO guidelines as majority of cancer patients suffered multiple types of pain.

Key Words: neuropathic pain • opioids • WHO analgesic ladder • cancer pain • adjuvants

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 6, 447-451 (2009)
DOI: 10.1177/1049909108322288


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