Pain treatment practice according to the WHO analgesic ladder in cancer patients: eight years experience of a single center

In this study we evaluated the results of pain treatment practices according to the World Health Organization analgesic ladder treatment. and other treatment modalities in cancer patients who were admitted to an anesthesiology-based pain service. Patient characteristics, distribution of the patients according to the primary pathologic sites, initial and last distribution of the patients according to analgesic ladder treatment, other invasive or non-invasive treatment modalities, side effects, and other data related with the patients were examined. 416 of 475 (87.5%) patients were treated using the WHO analgesic ladder treatment, 57 patients (12 %) were treated by invasive techniques. The number of successfully treated patients in step I, II and III were 49 (11.77%), 307 (73.79%) and 60 (14.42) respectively. 181 of 416 (43.50%) patients used anticonvulsants or neuroleptics, 341 of 416 (81.97%) patients used antidepressants. In 31 of 416 patients (7.5%), non-invasive or invasive treatment modalities had become necessary to augment the WHO analgesic ladder treatment. Over the entire treatment period, side effects were reported in 17.05% of the patients. The follow-up time for the patients was 42 +/- 109.7 days, the mean interview number was 5.6+/-7.6, the longest follow-up time was 1380 days, and the maximum number of the interviews made by the same patient was 68. In conclusion, we think that, using the World Health Organization analgesic ladder treatment and administering appropriate analgesics and adjuvants in appropriate oral doses determined for appropriate subjects could successfully treat a great number of these patients.