S186 European Journal of Pain 2006, Vol 10 (suppl S1) Abstracts, 5th EFIC Congress, Free Presentations

were gastrointestinal complaints. Most AEs were mild or moderate inseverity, and occurred during the first 2 weeks of treatment.Conclusions: Although there was no statistically significant effect on theprimary measure, benefits observed using other imputation methods andsecondary measures demonstrated the efficacy of OROS® hydromorphonein this population.

D16 PATIENT CONTROLLED ANALGESIA

712ECONOMIC EVALUATION OF THE FENTANYL HCLPATIENT-ACTIVATED TRANSDERMAL SYSTEM (ITS) INACUTE POST-OPERATIVE PAIN MANAGEMENT (POPM) INBELGIUM

L. Annemans1 °, E. Hunsche2, E. Spaepen1, L-A. van Bellinghen1,Y. Choe2, S. Kavanagh3. 1IMS Health, Belgium, and Ghent University,Belgium, 2Johnson & Johnson, Pharmaceutical Services, Raritan, NJ,USA, 3Janssen Pharmaceutica NV, Beerse, Belgium

Background and Aims: ITS is a new patient-activated transdermalsystem for POPM in the hospital setting. This study estimated the cost-effectiveness of ITS versus current POPM in Belgium.Methods: A decision analytic model was developed to estimate costs andeffectiveness of two sequential treatment arms from surgery to dischargefor an average patient experiencing moderate to severe post-surgical pain.In the base-case, treatment sequences consisted of 2 days intravenouspatient-controlled analgesia (IV-PCA) followed by 4 days IV non-opioidsand 1 day oral non-opioids (current care) compared with 2 days of ITSand 5 days of oral non-opioids (ITS). Effectiveness data were obtainedfrom ITS trials and published literature. Resource use and respectivecosts included drugs, consumables, and equipment, derived from a multi-center costing study and the literature, POPM-related complications, basedon a Belgian hospital database analysis, and staff time, estimated dur-ing four European Delphi panels. Sensitivity analyses were performedregarding key model assumptions and data inputs, including treatmentsequences/durations.Results: A patient’s probability of being successfully treated (adequatepain control and no complications) was similar in both groups (73%current care, 74% ITS). Total costs per patient were €2,789 and €2,608with current care and ITS, respectively; the cost of ITS was offset bysavings resulting from reduced staff time and fewer complications. Themodel was sensitive to assumptions regarding reductions in IV line-relatedcomplications (savings varying between €154.4 and €190.0 per patient).Conclusions: ITS is cost-effective in the acute POPM versus currentstandard therapy in Belgium.

713FENTANYL HCL IONTOPHORETIC TRANSDERMAL SYSTEM(ITS) SAVES STAFF TIME COMPARED TO INTRAVENOUSPATIENT-CONTROLLED ANALGESIA (IV-PCA) IN ACUTEMODERATE-TO-SEVERE POSTOPERATIVE PAIN

F. Bonnet1 °, L. Eberhart2, E. Wennberg3, S.J. Dodds4, M. Friberg5,Y. Choe6. 1Department d’Anesthesie, Reanimation, Hopital Tenon,Paris, France, 2Philipps-Universitat Marburg, Marburg, Germany,3Sahlgrenska Universitetssjukhuset, Sahlgrenska, Sweden, 4EdinburghUniversity, Royal Edinburgh Infirmary, Edinburgh, Scotland, UK, 5H SRigshospitalet, Copenhagen, Denmark, 6Health Economics, Johnson &Johnson Pharmaceutical Services, LLC, Raritan, NJ, USA

Background and Aims: Current postoperative pain management is staff-intensive. This study assessed differences in staff time between intravenouspatient-controlled analgesia (IV-PCA) and fentanyl HCl iontophoretictransdermal system (ITS), a new analgesic modality for acute moderate-to-severe postoperative pain.Methods: Four Delphi panels were convened with nurses (n = 36) andanesthesiologists (n = 14) from six European countries, who had previousexperience with IV-PCA and had participated in an ITS clinical trial. They

were provided a list of patient-care tasks and asked to estimate total timespent on each task over a course of IV-PCA or ITS for a typical patient.Staff time per task was calculated by multiplying the proportion of patients,for whom the task was usually performed, by the number of times the taskwas performed and by the task time. Times (minutes) were analyzed bycountry and for all countries combined.Results: ITS saved, on average, an estimated 68 minutes total stafftime compared to IV-PCA (88 versus 156 minutes) per patient for theaverage duration of either IV-PCA (52 hours) or ITS (56 hours). The mosttime consuming tasks were related to “Routine patient care” (44 versus57 minutes for ITS and IV-PCA, respectively). Time savings with ITSversus IV-PCA were found regarding ‘Set-up’ (19 versus 48 minutes),‘Troubleshooting’ (5 versus 13 minutes), and ‘Discontinuation’ (5 versus21 minutes) due to elimination of tasks associated with pumps, catheters,or IV lines.Conclusions: ITS is estimated to require 44% less staff time than IV-PCAthereby effectively decreasing staff workload.

714CONTROLLED – RELEASE (CR) OXYCODONE FOR THETREATMENT OF IATROGENIC NEUROPATHIC PAIN INPATIENTS WITH HEMATOLOGIC MALIGNANCIES

C. Cartoni °, G.A. Brunetti, G.M. Delia, R. Foa. Department of CellularBiotecnologies and Hematology Policlinico Umberto I, University LaSapienza, Rome, Italy

Background: Iatrogenic neuropathic pain is a distressing symptom fre-quently affecting patients with hematological malignancies. Oxycodonehas been previously shown to have an effect on peripheral neuropathicpain relief.Aims: an observational trial to evaluate the effectiveness and the safety ofCR oxycodone for the treatment of painful neuropathy due to non cancercauses.Patients and Methods: sixteen patients (10 myeloma, 3 lymphoma, 3leukemia, median age 62 yrs.) with neuropathic pain (9 drug-related: 8 dueto bortezomib, 1 to vinca alkaloids; 3 to H. Zoster; 4 to infections) receivedoral CR-oxycodone at the starting dose of 10mg bid. Pain intensity wasevaluated at baseline, day 3, 7 and 14 by using the numerical rating scale(NRS) along with the global patient evaluation of efficacy (GPE).Results: NRS was 7.4 at baseline, 3.7 after 3 days, 2.3 after 7 days. Theaverage NRS was 1.2 on day 14. GPE was very good in 5 patients, goodin 8 pts, satisfactory in 2 pts. On patient dropped out after 7 days forside effects. The daily average dose of CR-oxycodone administered was20mg (range 20−80mg). Ten patients used rescue doses of immediate-release oral morphine for breakthrough pain. 10 patients experienced lightto moderate drowsiness, 1 severe confusion, 7 pts. moderate constipation,4 pts. dry mouth.Conclusions: CR-oxycodone was effective in the control of the treatment-related neuropathic pain and caused mild toxicity. A good pain controlallowed the continuation of the cancer treatment.

715ANTINOCICEPTIVE EFFECTS OF DEXTROMETHORPHANON CHRONIC PAIN IN RATS IN COMPARISON WITH THEMORPHINE SULFATE

M.H. Dashti-Rahmatabadi °, F. Sadloo, A. Rafati. Dept of Physiology,Shahid Sadoughi Medical University, Yazd Iran

Background and Aims: Pain is one of the most common unpleas-ant experience which is usually associated with tissue. Opioids are themost effective analgesics but they induce serious side effects such asdependence. So approaching to alternative antinociceptive agents hasbeen the aim of many investigations. Since some evidence indicates thatDextromethorphan has some analgesic effect without any dependency, soin this study antinociceptive effect of Dextromethorphan on chronic painin rats in comparison whit morphine was assessed.Methods: In this way 49 wistar male adult rats weighting 200–250 gr wererandomly divided in to 7 groups and were kept in the same environmental