Pharmacologıcal Requırements For Intravenous Sedatıon in Oncologıcal Patıents Undergoıng Chronıc Opıoıd Analgesıc Treatment Durıng Percutaneous Interventıonal Procedures

Objective: To describe the pharmacological requirements of the doses used for fentanyl, propofol and midazolam, during intravenous sedation in oncology patients with chronic opioid analgesic treatment undergoing percutaneous interventional procedures. Materials and methods: An observational, retrospective, cross-sectional, and descriptive study was conducted after obtaining approval from the Research and Ethics Committee. Information was obtained through the review of clinical records of patients undergoing interventional procedures for oncological pain at the Pain Clinic of the National Cancer Institute between March 1st, 2020, and February 29th, 2024. A descriptive statistical analysis was performed, followed by a bivariate analysis using Chi-square and ANOVA tests to identify the association between chronic opioid analgesic treatment and pharmacological requirements in our population. Results: A total of 494 patients were studied, of whom 68.6% were female (n = 339) and 31.4% were male (n = 155). 99% of the patients were between 45 and 70 years of age, with a mean age of 57.66 years. The most frequently identified oncological diagnoses in our population were: breast cancer (20.4% of cases) (n = 101), multiple myeloma (14.2% of cases) (n = 70), and cervical cancer (12.6%) (n = 62). Regarding opioid analgesic treatment for pain control prior to the interventional procedure (n=494), 438 patients (88.6%) were identified as receiving opioid treatment (average Morphine Equianalgesic Daily Dose:56 mg), while only 56 patients (11.3%) were not. We found a trend toward greater use of fentanyl during intravenous sedation in patients without chronic opioid use compared to the group of patients with chronic opioid use. With respect to midazolam and propofol, similar requirements were found between the groups. No significant correlation was identified between the dose of intravenous sedation drugs and chronic drug use. Conclusions: There was no correlation on the average doses of midazolam, fentanyl and propofol in patients with chronic pain treatment who underwent percutaneous interventional procedures, regardless of whether they were on analgesic treatment or not. Prospective studies are required to corroborate these results. Keywords: Opioids, percutaneous interventional procedures, cancer pain, intravenous sedation.