Efficacy of partial opioid rotation of morphine to intravenous compound oxycodone for morphine-induced delirium in advanced cancer patients

TAKIGAWA Chizuko, KOMURA Yoshihiro, UEDA Keiko, MORIMOTO Yuji

doi:10.11321/jjspc.08-0007

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Other Title

終末期のモルヒネによるせん妄に対する複方オキシコドンへの一部オピオイドローテーションの有用性
シュウマツキノモルヒネニヨルセンモウニタイスルフクホウオキシコドンエノイチブオピオイドローテーションノユウヨウセイ

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The efficacy of opioid rotation of 20% of morphine to intravenous compound oxycodone, while giving 80% of the original dose of morphine, for morphine-induced delirium in cancer patients was studied. Thirty-two consecutive patients who were admitted and treated with intravenous morphine and developed delirium in a palliative ward were prospectively studied. Opioids were given by patient-controlled analgesia method. The degree of delirium, pain, and sleepiness was assessed by the Japanese version of Memorial Delirium Assessment Scale (MDAS-J), face scale (FS), and the Japanese version of Schedule for Treatment Assessment Scale (STAS-J), respectively, before and 3 days after partial opioid rotation to compound oxycodone. Five patients were excluded from the analyses because of changed management of pain control (n=2) and brain metastases (n=3). The results were analyzed in the remaining 27 patients. Delirium improved after partial rotation to compound oxycodone in 21 (78%) of the 27 patients. The mean degree of delirium improved from 16.2 to 9.2 on MDAS-J, pain from 2.2 to 1.7 on FS, and sleepiness from 2.6 to 1.7 on STAS. We conclude that partial rotation of morphine to compound oxycodone is effective to improve morphine-induced delirium in patients with cancer pain.

Journal

Journal of Japan Society of Pain Clinicians

Journal of Japan Society of Pain Clinicians 16 (2), 153-157, 2009

Japan Society of Pain Clinicians

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