2026-04-17T20:41:54Zhttps://recercat.cat/oai/requestoai:recercat.cat:10256/285862026-03-28T00:23:43Zcom_2072_452966com_2072_2054col_2072_452968
RECERCAT
author
Jiménez Carrascal, Ivan
2026-03-28T00:23:43Z
2026-03-28T00:23:43Z
2025-10
https://hdl.handle.net/10256/28586
Background: patients with chronic cancer pain are often treated with opioids for
pain relief. However, their exposure leads to tolerance and alterations in the
nociceptive signal, requiring increased doses to achieve the same pain control. This
is one of the reasons why this group is considered difficult to manage in
anaesthesiology. In addition, the lack of specific studies and protocols for this
population results in poorer analgesic management and an increase in
postoperative complications compared with opioid-naïve patients.
Objective: the main objective is to compare the effect of individualizing the
intravenous morphine rescue dose in PCA (Patient-Controlled Analgesia) devices
based on preoperative opioid dose on the proportion of patients achieving
acceptable pain control (Numerical Rating Scale ≤3 at rest, 24 h postoperatively)
compared with a standard PCA morphine dose, in opioid-tolerant patients
undergoing laparoscopic abdominal oncologic surgery.
Study design and participants: this trial is a randomised, double-blind,
multicentre, prospective, controlled trial that will study 336 patients (≥18 years)
exposed to ≥60 mg oral morphine equivalent for ≥7 days, scheduled for laparoscopic
oncologic abdominal surgery at Hospital Universitari Doctor Josep Trueta or
Bellvitge University Hospital over one year.
Methods: participating patients who have provided informed consent will be
randomised 1:1 into two groups: standard PCA morphine rescue dose according to
the institutional protocol or individualised PCA morphine dose adjusted to the
patient's preoperative oral morphine equivalent (OME). During the postoperative
stay in the Post-Anaesthesia Care Unit (PACU), patients will be controlled during the
first 24 hours, where they will receive multimodal analgesia according to the
protocol. At 24 hours, the proportion of patients with acceptable pain at rest (NRS
≤3) will be measured3
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
Dolor postoperatori
Pain, Postoperative
Morfina
Morphine
Analgèsia
Analgesia
Postoperative pain in patients with opioid tolerance: the importance of therapeutic individualisation
info:eu-repo/semantics/bachelorThesis