Interdisciplinar and multidimensional approach in neoplastic aged patients

Introduction: Pain is one of the main problems in dying cancer patients. In our experience, we evaluate the role of Continuous Infusion of Tramadol (CIT) In terminal cancer patients. Methods: In 44 dying patients with pain for bone metastases, we evalu• ated the effectiveness of CIT. In all patients Non Steroidal Anti-Inflammatory Drugs (NSA1.D) or Opiates (Op) has been used and stopped for Intoler• anceIuneffectiveness. In all patients we administered CIT 3 mcg/Kg/mln, adding rapid infusions of 50 mg if acute pain episodes occurred. We eval• uated Pain using a 10 points visive scale, and Pain Relief (PRl with an arbitrary 4-points scale: 0 =no improvement or worsening, 1 = improve• ment 01 less than 2 points, 2 • improvement of 2-4 points, 3 =Improvement of more than 4 points. We evaluated pain before and 3 days alter CIT beginning. Reaults: In 6 patients (13.6%) we observed a PR =0 and stopped the treatment; on the contrary, PR =1. PR =2, and PR =3 was observed respectively in 10 (22.8%), 6 (13.6%) and 22 (50%) patients. Mc>?e~te sedation, urinary disturbance and Intestinal constipation were the main SIde effects observed in 3 distinct patients. ConclusIon: In our experience CIT may represent an useful way to control pain In terminal cancer patients. Effectiveness and few side effects represent the best characteristics of the drug, In particular when NSAID or Op Intoleranceluneffectiveness occur.