Abstract
Context: Opioid therapy often shows insufficient efficacy and substantial adverse events in patients with advanced cancer. Objectives: To assess the efficacy of caffeine infusion as an adjuvant analgesic to opioid therapy in patients with advanced cancer. Methods: A double-blind, randomized, placebo-controlled trial was conducted in the palliative care wards of two teaching hospitals in South Korea. A total of 20 of 41 participants were assigned to the caffeine group and 21 to the placebo group. The participants received caffeine (200 mg) or normal saline intravenously once a day for two days. The primary outcome was pain, which was measured using a 10-point rating scale. Other outcomes included drowsiness, confusion, nausea, sleep disturbance, fatigue, and sadness. Results: Three participants (two in the caffeine group and one in the placebo group) dropped out after the first intervention because of insomnia; thus, 38 participants completed the trial. Pain score was significantly lower in the caffeine group than in the placebo group after the second trial (P = 0.038). The mean reduction in pain intensity in the caffeine group was 0.833 (95% confidence interval [CI] 0.601-1.066), whereas that in the placebo group was 0.350 (95% CI 0.168-0.532). Considering an improvement higher than 30% from baseline as the threshold value, drowsiness improved significantly in the caffeine group after the first trial (P = 0.041). Adverse event rate did not differ between the two groups. Conclusion: Caffeine infusion significantly reduced pain and drowsiness, but the reduction did not reach clinical significance in patients with advanced cancer undergoing opioid therapy. Further investigations are warranted.
| Original language | English |
|---|---|
| Pages (from-to) | 474-482 |
| Number of pages | 9 |
| Journal | Journal of Pain and Symptom Management |
| Volume | 46 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2013 Oct 1 |
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Keywords
- Caffeine
- cancer pain
- opioid therapy
- randomized controlled trial
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
- Clinical Neurology
- Nursing(all)
Cite this
Caffeine as an adjuvant therapy to opioids in cancer pain : A randomized, double-blind, placebo-controlled trial. / Suh, Sang Yeon; Choi, Youn Seon; Oh, Sang Cheul; Kim, Young Sung; Cho, Kyunghee; Bae, Woo Kyung; Lee, Ju Hyun; Seo, Ah Ram; Ahn, Hong Yup.
In: Journal of Pain and Symptom Management, Vol. 46, No. 4, 01.10.2013, p. 474-482.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Caffeine as an adjuvant therapy to opioids in cancer pain
T2 - A randomized, double-blind, placebo-controlled trial
AU - Suh, Sang Yeon
AU - Choi, Youn Seon
AU - Oh, Sang Cheul
AU - Kim, Young Sung
AU - Cho, Kyunghee
AU - Bae, Woo Kyung
AU - Lee, Ju Hyun
AU - Seo, Ah Ram
AU - Ahn, Hong Yup
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Context: Opioid therapy often shows insufficient efficacy and substantial adverse events in patients with advanced cancer. Objectives: To assess the efficacy of caffeine infusion as an adjuvant analgesic to opioid therapy in patients with advanced cancer. Methods: A double-blind, randomized, placebo-controlled trial was conducted in the palliative care wards of two teaching hospitals in South Korea. A total of 20 of 41 participants were assigned to the caffeine group and 21 to the placebo group. The participants received caffeine (200 mg) or normal saline intravenously once a day for two days. The primary outcome was pain, which was measured using a 10-point rating scale. Other outcomes included drowsiness, confusion, nausea, sleep disturbance, fatigue, and sadness. Results: Three participants (two in the caffeine group and one in the placebo group) dropped out after the first intervention because of insomnia; thus, 38 participants completed the trial. Pain score was significantly lower in the caffeine group than in the placebo group after the second trial (P = 0.038). The mean reduction in pain intensity in the caffeine group was 0.833 (95% confidence interval [CI] 0.601-1.066), whereas that in the placebo group was 0.350 (95% CI 0.168-0.532). Considering an improvement higher than 30% from baseline as the threshold value, drowsiness improved significantly in the caffeine group after the first trial (P = 0.041). Adverse event rate did not differ between the two groups. Conclusion: Caffeine infusion significantly reduced pain and drowsiness, but the reduction did not reach clinical significance in patients with advanced cancer undergoing opioid therapy. Further investigations are warranted.
AB - Context: Opioid therapy often shows insufficient efficacy and substantial adverse events in patients with advanced cancer. Objectives: To assess the efficacy of caffeine infusion as an adjuvant analgesic to opioid therapy in patients with advanced cancer. Methods: A double-blind, randomized, placebo-controlled trial was conducted in the palliative care wards of two teaching hospitals in South Korea. A total of 20 of 41 participants were assigned to the caffeine group and 21 to the placebo group. The participants received caffeine (200 mg) or normal saline intravenously once a day for two days. The primary outcome was pain, which was measured using a 10-point rating scale. Other outcomes included drowsiness, confusion, nausea, sleep disturbance, fatigue, and sadness. Results: Three participants (two in the caffeine group and one in the placebo group) dropped out after the first intervention because of insomnia; thus, 38 participants completed the trial. Pain score was significantly lower in the caffeine group than in the placebo group after the second trial (P = 0.038). The mean reduction in pain intensity in the caffeine group was 0.833 (95% confidence interval [CI] 0.601-1.066), whereas that in the placebo group was 0.350 (95% CI 0.168-0.532). Considering an improvement higher than 30% from baseline as the threshold value, drowsiness improved significantly in the caffeine group after the first trial (P = 0.041). Adverse event rate did not differ between the two groups. Conclusion: Caffeine infusion significantly reduced pain and drowsiness, but the reduction did not reach clinical significance in patients with advanced cancer undergoing opioid therapy. Further investigations are warranted.
KW - Caffeine
KW - cancer pain
KW - opioid therapy
KW - randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=84885291188&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885291188&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2012.10.232
DO - 10.1016/j.jpainsymman.2012.10.232
M3 - Article
VL - 46
SP - 474
EP - 482
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
SN - 0885-3924
IS - 4
ER -