Kousuke Yamanaka, Takaaki Hasegawa, Yoshinobu Matsuda, Shinichiro Inoue, Hitoshi Tanimukai, Saho Wada, Jun Kako
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引用次数: 0
Abstract
Background: Delirium is a common and distressing symptom in patients with cancer, while opioids-which are essential in managing cancer pain-can cause delirium. Opioid switching is a widely used strategy for the management of opioid-induced delirium; however, its efficacy is yet to be verified. This systematic review aimed to determine opioid switching's efficacy and safety for managing opioid-induced delirium in patients with cancer.
Methods: This systematic review was conducted in accordance with the PRISMA guidelines. We searched four databases (PubMed, Cochrane Controlled Register of Trials, Cochrane Library, and Ichishi-Web) on September 6, 2023, with an updated PubMed search on October 20, 2024. Our review included studies on opioid switching for managing delirium in patients with cancer. If there were less than two randomized controlled trials (RCTs), we included observational studies. Data extraction and evaluation were independently conducted by two reviewers using the GRADE evaluation. The study protocol was registered (UMIN000051787).
Results: The literature search identified seven observational studies without a control group; however, no RCTs were found. Four observational studies reported improvements in the severity of delirium symptoms. No study reported worsening pain or dyspnea after opioid switching. According to the GRADE framework, all outcomes were graded very low on certainty.
Conclusions: Although observational studies imply opioid switching's effectiveness for managing opioid-induced delirium in patients with cancer, there is a lack of RCTs and the level of evidence is very low. Thus, RCTs are warranted to confirm opioid switching's efficacy.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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