Observational studyScientific reports2026
Implementing measurement-based care in the analgesic management of cancer pain patients receiving intrathecal drug infusion.
Observational study in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
To evaluate the efficacy and safety of a structured measurement-based care (MBC) strategy with a "Monitor-Assess-Adjust" closed-loop protocol for managing moderate-to-severe cancer pain in patients receiving intrathecal morphine patient-controlled analgesia (IT-PCA). A retrospective observational study was conducted at two pain centers, enrolling 15 patients with cancer pain (Visual Analog Scale [VAS] ≥ 7). All patients initially received intravenous patient-controlled analgesia (IV-PCA) for dose titration, followed by IT-PCA implantation. A structured MBC protocol was implemented, including three core components: (1) Multidimensional assessment: regular evaluations using the VAS, Brief Pain Inventory (BPI), and leeds assessment of neuropathic symptoms and signs (LANSS) scale; (2) Dynamic individualized titration: a standardized dosing algorithm based on pain reassessment every 15 min during IT-PCA initiation, with adjustments as follows: 50-100% dose increase for unchanged/elevated VAS, 50% increase for VAS 4-6, and dose maintenance for VAS 1-3 (target: VAS < 4); (3) Systematic follow-up: assessments at baseline, post-IV-PCA, post-IT-PCA, discharge, and 1, 3, 6 months after discharge. After IT-PCA under the MBC protocol, the mean VAS score decreased significantly from 8.28 ± 0.76 at baseline to 2.14 ± 0.90, representing a 76.4% pain reduction (P < 0.05), and this effect was sustained throughout follow-up. Pain relief and quality of life (BPI scores) were significantly improved compared with baseline and post-IV-PCA stages (P < 0.01). Notably, the incidence of opioid-related adverse reactions was extremely low: only 1 patient (6.7%) experienced mild, manageable constipation, with no cases of nausea, vomiting, or respiratory depression. Implementing IT-PCA within an MBC framework enables effective, individualized analgesia, sustains long-term pain relief, and optimizes the therapeutic benefit-risk profile by minimizing adverse effects, thus improving the quality of life in cancer pain patients. This study provides evidence for a data-driven, precision medicine approach to intrathecal analgesia management.
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