Continuous sc infusion of narcotics for the treatment of cancer pain: An update

More than two-thirds of advanced cancer patients require narcotic analgesics. For patients requiring parenteral narcotics, a continuous infusion of narcotics is safe, has fewer side effects, and is also probably more effective than intermittent injections. The use of the sc route provides equianalgesic results to the iv route with more patient comfort and less potential toxicity. It also allows safe home discharges of patients who otherwise would need prolonged hospitalization. The method of administration of CSCI must be decided according to patient needs and characteristics of the institution where the treatment takes place. More research is needed into CSCI to better define the pharmacokinetics and the clinical effects of drugs administered with this technique, and to compare CSCI to new methods such as patient-controlled analgesia. The administration of other drugs such as steroids or antiemetics via the CSCI should also be further explored. We conclude that CSCI is safe and effective and should be regarded as the first choice in patients requiring parenteral analgesia.