Abstract
We constituted critical pathway to relief pain as quickly as possible with lesser adverse effect of opioid for noncurative cancer patients. We made out it with Microsoft Excel, and used on personal computers. In this critical pathway, “good sleeping” was set as first goal and second was “no pain in rest position”. Medications for pain relief are controlled release oxycodone plus NSAIDs and prochlorperazine, stool softener and peristaltic stimulant for adverse effects. The components for everyday assessment include the levels of pain, nausea/ vomiting, constipation, somnolence and hallucination. These outcomes lead the dosage change of opioid and/ or medicinal substitution for next day by calculation using visual basic function due to opioid titration experience. Ten patients were acceptable this critical pathway and all of them achieve the second goal within a week without severe adverse effect except for constipation rarely needed enema and/or removing by finge.
