Evidence map›Paper›PMID 38180558›Full record

SynthesisNaunyn-Schmiedeberg's archives of pharmacology2024

Effectiveness of epidural morphine for the treatment of cancer pain in patients with gastrointestinal neoplasm-a systematic review.

Yasmim Jianjulio Nassif, Maria Elisa Zanin, Joselin Valeska Martinez-Sobalvarro, Carlos Marcelo de Barros, Maurílio Pacheco-Neto, Tiago Marques Dos Reis, Márcia Helena Miranda Cardoso-Podestá, Larissa Helena Torres

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Naunyn-Schmiedeberg's archives of pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yasmim Jianjulio NassifDepartment of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Centro-Alfenas, MG, CEP: 37130-001, Brazil.ORCID http://orcid.org/0009-0000-8044-7715
Maria Elisa ZaninDepartment of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Centro-Alfenas, MG, CEP: 37130-001, Brazil.ORCID http://orcid.org/0009-0007-2000-5879
Joselin Valeska Martinez-SobalvarroDepartment of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Centro-Alfenas, MG, CEP: 37130-001, Brazil.ORCID http://orcid.org/0000-0002-7074-4609
Carlos Marcelo de BarrosDepartment of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Centro-Alfenas, MG, CEP: 37130-001, Brazil.ORCID http://orcid.org/0000-0002-1207-2867
Maurílio Pacheco-NetoSchool of Medicine, Sapucai Valley University, Pouso Alegre, Brazil.ORCID http://orcid.org/0009-0008-8353-6615
Tiago Marques Dos ReisDepartment of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Brazil.ORCID http://orcid.org/0000-0002-0789-0187
Márcia Helena Miranda Cardoso-PodestáDepartment of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Centro-Alfenas, MG, CEP: 37130-001, Brazil.ORCID http://orcid.org/0000-0002-3246-1907
Larissa Helena TorresDepartment of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Centro-Alfenas, MG, CEP: 37130-001, Brazil. larissa.torres@unifal-mg.edu.br.ORCID http://orcid.org/0000-0002-7065-7484

Funding

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Finance Code 001Fundação de Amparo à Pesquisa do Estado de Minas Gerais PIBICT/FAPEMIG 17/2021Fundação de Amparo à Pesquisa do Estado de Minas Gerais PPSUS/FAPEMIG, APQ-03735-17
6 · The paper itself

Abstract

One-third of cancer pain patients do not experience adequate pain relief using analgesic ladder by the World Health Organization. Interventional procedures, such as epidural morphine, have been considered. This study aimed to review the literature comparing the effects of epidural administration of morphine with the oral route. This systematic review included randomized controlled trials (RCTs) conducted with patients with gastrointestinal neoplasm. A search was conducted on PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, and CINAHL databases to identify studies published up to May 2023. The retrieved study was evaluated using the Risk of Bias 2 (RoB 2) tool and qualitatively synthesized. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach (Prospero: CRD42021264728). Only one RCT, a crossover trial, was included in this systematic review. The study was conducted with ten participants (one withdrawal) and reported a statistically significant difference between both subcutaneous and epidural morphine solutions and oral morphine. The adverse events were not described. The included study presents some concerns of bias and low certainty of evidence on the effectiveness and security of epidural morphine administration. The available literature does not suffice to elucidate whether morphine administration via the epidural route is more effective than other routes. Further RCTs are necessary to improve the level of evidence on the effectiveness and risk-benefit of epidural morphine in the management of cancer pain in gastrointestinal neoplasm patients.

Indexed as

Analgesia, EpiduralAnalgesics, OpioidCancer PainGastrointestinal NeoplasmsMorphineRandomized Controlled Trials as TopicAdministration, OralHumansTreatment OutcomeAnalgesics, OpioidMorphineAbdominal neoplasmsCancer painEpidural analgesiaGastrointestinal neoplasmMorphineRandomized controlled trial

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.