Preventive effect of pre-warming, hot compress, and pH adjustment in oxaliplatin-induced venous pain

Abstract

Background Venous pain induced by peripheral intravenous administration of oxaliplatin remains clinically unresolved. Objective The aim of this study was to determine the efficacy of comprehensive intervention care for venous pain in colorectal cancer patients receiving oxaliplatin. Setting A Japanese tertiary hospital. Method We treated all outpatients after April 2012 with comprehensive intervention care including pre-warming of the oxaliplatin solution, use of a hot compress, and pH adjustment by combination with dexamethasone. We retrospectively reviewed the electronic medical records from colorectal cancer patients who had received oxaliplatin via a peripheral vein between December 2009 and June 2014. Main outcome measures The primary endpoint of this study was the incidence of venous pain at the administration site during oxaliplatin infusion, according to injection site reaction grade ≥ 2. Results We evaluated 271 treatment courses in 59 patients. Venous pain occurred in 42 courses (15.5%) among 26 patients. Multivariate logistic regression analysis revealed that female gender and body mass index ≥ 25 kg/m were significantly associated with an increased risk of venous pain during all courses (adjusted odds ratio [OR]: 3.18, 95% confidence interval [CI] 1.35-7.92; P < 0.01; and adjusted OR: 3.37, 95% CI 1.26-9.40; P = 0.02, respectively), whereas comprehensive intervention care were significantly associated with reduced risk of venous pain during all courses (adjusted OR: 0.10, 95% CI 0.02-0.44; P < 0.01). Conclusion Comprehensive intervention care is a clinical treatment option for oxaliplatin-induced peripheral venous pain in patients with colorectal cancer, especially females with obesity.

Evaluation of vascular pain in patients with colorectal cancer receiving peripheral venous chemotherapy with or without oxaliplatin

“…Co-infusion of dexamethasone 7 , prewarming peripheral blood vessels 16 , premedication with oxycodone, and altering the dose rate have all been investigated as countermeasures against oxaliplatin-induced vascular pain 6 . The effects of many of these countermeasures on vascular pain were assessed by VAS.…”

“…Heating the blood vessels is thought to reduce vascular pain 16 . Furthermore, blood flow is known to increase with increasing vessel diameter 17 , and Hagen Poiseuille’s equation showed that blood flow increased in proportion to the fourth power of the vessel diameter 18 .…”

Risk Factors for Gemcitabine-Induced Vascular Pain in Patients With Pancreatic Cancer

“…Additionally, it was reported that warming the blood vessels might reduce oxaliplatin-induced venous pain. 19 Therefore, it was proposed that the application of a hot pack would result in the dilation of blood vessels, which may be useful to reduce symptoms of vascular pain after intravenous gemcitabine administration. Indeed, as shown in Figure 1B, our results indicated that the incidence of vascular pain in patients with hot pack use was significantly lower than that in patients without hot pack use, with dosages >930 mg/m 2 .…”

“…These approaches include accessing the large vein in the crease of the forearm for peripheral venipuncture, reducing the speed of administration, increasing the volume of dilution, 14,15 addition of dexamethasone into the solution for pH adjustment, 16,17 administration through a Y-site of the main infusion route of a hydration bag, 18 and warming the vein with a hot pack. 19 However, the efficacy of these methods for preventing vascular pain caused by administration of anticancer drugs, including gemcitabine, has not been fully elucidated.…”

Gold nanorods together with HSP inhibitor-VER-155008 micelles for colon cancer mild-temperature photothermal therapy

“…We believe that the graphene @VER-M or nano Fe 3 O 4 @VER-M system would be useful for mild PTT in the future. Or more succinctly, other kinds of heat treatments for cancer therapy such as hot compress 80 and hyperthermic perfusion 81 could be enhanced by forming hot compress@VER-M or hyperthermic perfusion@VER-M system.…”