Evaluation of who guided pain management protocol in cases of carcinoma cervix

Abstract

INTRODUCTIONCancer cervix is one of leading cause of cancer death among women worldwide. It is the commonest malignancy to affect women of all ages in the developing countries, accounting for an estimated 370,000 new cases and 160,000 deaths per year. The incidence of late disease in most of the affluent countries is about 10-12%. Incidence of new cancer patients in India is about 100,000 per year and 70% or more of these are stage III or higher at the time of diagnosis. 1 Pain is a debilitating symptom associated with cancer cervix. It occurs in 25-50% patients with newly diagnosed malignancies, in more than 75% of those with advanced disease, and in 33% of those undergoing treatment. 2 Pain in patients with cancer cervix is a complex process that occurs from many causes. Ninety percent of pain in cancer cervix results from the tumor itself or therapy in which 70% of pain develops from tumor invading or compressing uterosacral ligament and sacral plexus, and 20% of cancer pain related with its treatment (radiation ABSTRACT Background: Pain in patients with cancer cervix is a complex process that occurs from many causes. Opioids, the major class of analgesic used in management of moderate to severe pain, are usually effective and have favorable benefit to risk ratio. Morphine is the most effective and commonly used opioid in cancer pain management. Methods: Patients of cancer cervix attending the Obstetrics and Gynecology Department, KRH for a period January 2016 to December 2016. 200 patients were included in the study. Pain intensity was measured by visual analogue scale. Results: Maximum number of subjects were in stage IIB (46%) followed by stage IIIB (42%). Minimum number of subjects were in stage IA and stage IVB. In stage I, 55.6% patients had mild pain, 27.8% had moderate and 16.7% patients had severe pain. In stage II, carcinoma cervix patients 80.4% patients had moderate pain and only 12% patients had severe pain and stage III, 47.6% patients had severe pain and stage IV all patients had severe pain. Most common site for pain was lower abdomen in carcinoma cervix patients. The pain was recorded as moderate in maximum (49%) subjects followed by severe (39%). Mild pain was seen only in 12% subjects. Maximum response was seen for Step III (95.1%) while minimum for Step II (44.1%). Conclusions: Pain is a common symptom in cancer cervix patients. Morphine is most useful drug in cancer pain management. It is easily titratable and has a favorable benefit to risk ratio.

Spinal Anesthesia Ambulation Time of Cervical Cancer Brachytherapy Outpatient Clinic: Comparison of 5 mg Hyperbaric Bupivacaine Fentanyl with 2,5 mg Hyperbaric Bupivacaine and 25 mcg Fentanyl

“…1 Cervical cancer is the leading cause of cancer death in women worldwide. 2 dissection for the early stages, plus radiation and chemotherapy. In women with advanced cervical cancer, standard care may be external beam radiation therapy (EBRT) alone, EBRT and brachytherapy, or combining EBRT and brachytherapy with current chemotherapy.…”