Avaliação da eficácia da via peridural no tratamento da dor oncológica de difícil controle em pacientes com neoplasia gastrointestinal avançada em cuidado paliativo

Abstract

Pain is the most critical symptom that accompanies cancer, however, its treatment is not always effective. Therefore, the study aimed to compare the efficacy of oral treatment with morphine and adjuvants to the treatment with morphine and epidural ropivacaine, in the control of cancer pain in patients with gastrointestinal cancer in palliative care in the Unified Health System (SUS), whose pain presents difficulties of clinical control. This was a randomized clinical trial with two groups: control and intervention. The control group received morphine and adjuvants orally. The intervention group received morphine and ropivacaine peridurally. Patients were evaluated in four phases using various scales to assess treatment efficacy and compliance. The results showed that treatment with epidural morphine and ropivacaine was significantly more effective in maintaining analgesic treatment, leading to greater treatment compliance, especially in the more advanced stages of the disease. The intervention group had a lower treatment failure rate and less pain in Phase 2. However, the patients in this group also had worsening functional clinical status in some phases of the study. Based on these results, it is concluded that treating cancer pain with epidural morphine and ropivacaine may be a more effective option for patients with gastrointestinal neoplasia in palliative care on the SUS.