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Oxaliplatin infusion-related venous pain: prevention by simultaneous intravenous fluids
  1. Stefan van Ravensteijn1,2,
  2. Britt van Merrienboer1,
  3. Stefan van Asten1,
  4. Johannes Pruijt1,
  5. Mirrian Hilbink1 and
  6. Jolien Tol1
  1. 1 Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
  2. 2 Internal Medicine, Radboudumc, Nijmegen, The Netherlands
  1. Correspondence to Dr Jolien Tol, Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch 5223 GZ, Noord-Brabant, The Netherlands; j.tol{at}jbz.nl

Abstract

Objective Oxaliplatin is a cytotoxic agent frequently used in the treatment of gastrointestinal cancer patients. A known side effect of oxaliplatin administration via a peripheral vein is infusion-related pain. In this retrospective cohort study we compared the incidence of infusion-related pain in patients treated with oxaliplatin with or without simultaneous fluid infusion (FI) (800 mL glucose 5% in 2 hours).

Methods We retrospectively defined two cohorts: Patients treated with oxaliplatin and simultaneous intravenous FI and the same number of patients treated without FI.

The incidence of infusion-related venous pain was the primary outcome measure. Secondary outcomes included: Incidence of hypersensitivity reactions, infusion time, dose density, number of patients switched to a central venous catheter and incidence of peripheral neuropathy.

Results 100 patients were included, 50 patients in both groups. Baseline characteristics were comparable, except for age (median 66.8 vs 62.4 years in groups with and without FI; p=0.017), and body mass index (28.0 vs 25.7 kg/m2, respectively; p=0.012). Patients treated with simultaneous FI experienced significantly less vascular pain compared with those without FI (10% vs 78%, respectively; p<0.0001; OR 0.031 (95% CI: 0.01 to 0.098)). No difference was observed in dose density, treatment delay or the need of central venous catheter. Logistic regression analysis showed no confounders affecting the primary outcome. No adverse events of FI were observed.

Conclusion Concurrent infusion of 800 mL glucose 5% with peripheral venous administration of oxaliplatin significantly reduces the incidence of infusion-related pain in gastrointestinal cancer patients and is highly feasible and affordable in everyday clinical practice.

  • gastrointestinal (lower)
  • gastrointestinal (upper)
  • drug administration
  • hospital care
  • pain
  • peripheral vascular disease

Data availability statement

All data relevant to the study are included in the article

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Data availability statement

All data relevant to the study are included in the article

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Footnotes

  • Contributors Study concepts: SvR, JT, BvM, SvA. Study design: SvR, JT. Data acquisition: SvR, SvA, JT. Quality control of data and algorithms: SvR, JT, MH. Statistical analysis: SvR, MH, JT. Manuscript preparation: SvR, BvM, SvA, JP, MH, JT. Manuscript review: SvR, BvM, SvA, JP, MH, JT.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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