Use of the Edmonton Injector for parenteral opioid management of cancer pain: A study of 100 consecutive patients

Abstract

In this retrospective study, we reviewed the patterns of use of the Edmonton Injector (EI) in 100 consecutive cancer patients. Seventy-eight patients used the EI for an average of 23 +/- 27 days. The main reasons for starting the EI were nausea (37 patients) and severe pain (31 patients). The median opioid dose equivalent to parenteral morphine (MEDD) was 264 +/- 443 mg/day. The mean duration of the subcutaneous injection site was 6.5 +/- 9.2 days. The most frequent reasons for change were accidental needle pulling (59%) and erythema (12%). Only two patients developed local infection (1% of 196 sites). The average cost of treatment was $1.65 Canadian per patient per day. No mechanical problems or refusals to start or continue treatment were detected. We conclude that the EI is a safe and simple device that allows for cost-effective parenteral administration of opioids for cancer pain.

Intermittent Subcutaneous Opioids for the Management of Cancer Pain

“…The 8-day overall duration of the sites was slightly longer than previously reported for intermittent infusions (6.5 days) 8 and for continuous infusions of opioids (7 days). 20 In contrast with our previous data, no site infections were detected and accidental needle pulling was reported in only one case (Ͻ 1%).…”

“…The median (interquartile range, IR) duration of the Edmonton Injector use was 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) days. The median (IR) number of sites per patient was 1 (1-2), ranging from 1 to 14, and the mean (standard deviation) site duration was 8 PARSONS ET AL.…”

“…8 Since then (for the last 17 years) the TPCU has been performing intermittent SC opioid injections with the Edmonton Injector.…”

“…It was necessary to change route from the SC to the IV in 8 of 301 (3%) admissions, very low as previously described for our setting. 8 The use of intermittent injections was considered a failure because of side effects in only 4 of 301 (1%) of the admissions.…”

“…[5][6][7] Intermittent subcutaneous opioid administration with an indwelling subcutaneous butterfly needle is a painless and inexpensive way of achieving pain control in those patients. [7][8][9][10] The Edmonton Injector is a portable, simple, safe, and inexpensive mechanical device for delivering subcutaneous drugs. 11 The purpose of this study is to review the results of intermittent SC opioids in a consecutive series of patients with cancer.…”