Serum Lactate Dehydrogenase Levels May Predict Fentanyl Usage in Patients with Metastatic Cancersfor The Treatment of Cancer Related Pain
Giriş: Opioid aşırı kullanımı sağlık sağlayıcıları ve denetleyicilerinin dikkatini çekmeye başlamıştır. Ancak diğer taraftan ise kanser hastalarındaağrı en sık semptom olmanın yanında ileri evre vakalarda ağrı sıklıkla hayat kalitesinin de düşürmektedir. Bu çalışmada rutin biyokimyasalparametreler ile opioid dozları arasındaki ilişkiyi aşırı kullanımı önlemek amacıyla araştırdık.Metod: 75 ileri veya metastatik evrede kanser hastasını takip ettik. Medikal kayıtlar retrospektif olarak incelendi.Bulgular: 75 hastanın yaş ortalaması 58(34-80) olup 54 erkek ve 21 hasta kadındı. En sık metastaz yeri 40 (%53) hastada kemik iken, 20 (%26)hastada lenf nodu, 10 (%13) hastada karaciğer, ve 7 (%9) hastada beyin idi. Tüm hastalar Comparative Pain Scale (CPS) skorlaması ile takipedildi ve ortanca CPS skoru tedavi öncesi 5 (3-9) iken takiplerde anlamlı derecede azalma gösterdi, CPS değeri 2 (0-6), P<0.001. Korelasyonanalizinde tüm biyokimyasal değerler ile analjezikler dozları ile karşılaştırıldı. Serum laktad dehidrogenaz düzeyleri fentanil dozu arasındaanlamlı ilişki bulundu (Pearson correlation was 0.33, P=0.003).Sonuç: Kanser tiplerinden bağımsız olarak artmış serum LDH düzeyleri fentail dozu ve CPS skoru ile anlamlı olarak ilişkili bulunmuştur.Anahtar Kelimeler Serum laktad dehidrogenaz, ağrı, opioid, fentanil
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