Can adequate analgesia be achieved in patients with cirrhosis without precipitating hepatic encephalopathy? A prospective study.
Brief Pain Inventory
liver disease
modified orientation log
pain
sedation
Journal
Clinical and experimental hepatology
ISSN: 2392-1099
Titre abrégé: Clin Exp Hepatol
Pays: Poland
ID NLM: 101703431
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
03
04
2020
accepted:
11
06
2020
entrez:
4
11
2020
pubmed:
5
11
2020
medline:
5
11
2020
Statut:
ppublish
Résumé
Analgesic use in patients with liver cirrhosis can be associated with increased morbidity and mortality and presents clinicians with a significant and challenging management issue. We evaluated the efficacy of opiate analgesia in patients with cirrhosis, while closely monitoring the side effect profile. This prospective cohort pilot study compared inpatients with cirrhosis who required regular opiate analgesia to non-cirrhotic patients requiring opiates and patients with cirrhosis who did not require opiates. Participants completed daily surveys to assess for analgesic efficacy and encephalopathy. Fifty-two patients were initially recruited, of whom 50 patients were analysed in three groups (40 male, 10 female, median age 52 years). These included 13 cirrhotic patients (69% Child-Pugh B or C) requiring regular opiate analgesia, 18 cirrhotic patients (67% Child-Pugh B or C) not receiving regular opiate analgesia, and 19 non-cirrhotic controls. Two patients were excluded due to past stroke and acquired brain injury. All cirrhotic patients received regular lactulose. There was no statistical difference in the adequacy of analgesia between the three groups. The modified orientation log score for encephalopathy remained in the normal range in all but two cirrhotic patients receiving regular opiate analgesia. Effective pain control is achievable with opiate analgesia in most patients with advanced liver disease without precipitating hepatic encephalopathy.
Identifiants
pubmed: 33145431
doi: 10.5114/ceh.2020.99521
pii: 41918
pmc: PMC7592086
doi:
Types de publication
Journal Article
Langues
eng
Pagination
243-252Informations de copyright
Copyright © 2020 Clinical and Experimental Hepatology.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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