Continuous narcotic infusion with patient-controlled analgesia for chronic cancer pain in outpatients

To determine the feasibility and safety of outpatient continuous narcotic infusions with additional bolus capabilities (patient-controlled analgesia) in patients with cancer pain.

A single arm (non-randomized) series.

Outpatient with contact by telephone and through outpatient clinic.

Consecutive series of 18 patients with poorly controlled cancer pain or significant side effects from regular administration of various narcotics.

Patients taught and supervised to use portable pump capable of delivering a continuous narcotic infusion with bolus capabilities.

All patients had improvement in pain control as judged by the use of a linear analogue scale. Side effects and safety profile were highly acceptable. Narcotics used and maximum doses were meperidine, 50 mg/h; morphine, 80 mg/hr; and hydromorphone, 60 mg/hr. Infusion duration ranged from 7 to 225 days (mean, 54 days).

Continuous narcotic infusions using a programmable portable pump with bolus capabilities is a safe and reliable method of delivering narcotics to outpatients.