Avaliação do hábito intestinal e do tratamento da constipação de pacientes com tumores pediátricos em uso de morfina

• Autor(a) principal: Marmo, Michela Cynthia da Rocha [UNIFESP]
• Data de Publicação: 2010
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/9089
• topic: Morfina; Neoplasias; Constipação intestinal; Morphine; Neoplasms; Constipation

Objective: Evaluate bowel habit in cancer patients using morphine. Analyze the effectiveness of a therapeutic program in controlling constipation secondary to opioid. Method: case study series, non-randomized, prospective. Patients admitted in the study were bearers of cancer, aged over four years, and using morphine for pain control. After 24 hours from the beginning of the use of morphine, patients were given lactulose and in refractory cases, bisacodyl. Evaluation of bowel habit was achieved through a structured questionnaire. When necessary, fecal desimpaction was performed by via anal or oral. Results: 22 patients were admitted to the study, aged between five and 15 years (average 16.7 years). 27% (6/22) patients had constipation before admission in the study. In the first week of use of morphine and lactulose, 40% (9/22) patients had constipation. In the second and third weeks, constipation occurred in 38.8% (7/18) and 16% (2/12), respectively. The therapeutic protocol adopted was able to control the constipation in 57% (11/22) of cases. Conclusions: constipation has been frequent in patients who have used morphine, 40%, 38.8% and 16% respectively in the first, second and third weeks despite the prophylactic treatment with laxatives. However, the protocol with specific attention to constipation can increase adherence to laxatives and minimize the complications of constipation, such as the appearing of fecaloma. Controlled studies are needed with largest number of cases for the development of effective therapeutic strategies, such multi-professional approach, which reduce the suffering of cancer patients who need to use morphine.