Abstract :
To assess pain in cases of cancer cervix and to evaluate the response to pain management
according to WHO step ladder pattern in cases of cancer cervix, total 209 carcinoma cervix
diagnosed and admitted case were recruited in the study. Baseline pain score was measured for
each patient. For mild to moderate pain (VAS ≤ 7) , step 1 analgesic, NSAID, diclofenac sodium(50 mg TDS) was prescribed. Pain scores were reevaluated after 48 hrs and change of score was
recorded. If pain persisted (same score), worsened (score increased) or score decreased but with
a VAS score of > 4 , case was considered as non responder and patient was switched to step 2
analgesic. Step 2 was also applied directly to patients presenting with severe pain ( VAS >7) at
the time of recruitment. Drugs used in step 2 was oral tramadol (50 mg QID ) along with Diclofenac ( 50 mg TDS) . VAS Score
was reevaluated after 48 hrs. If score still remained above 4; adjuvant analgesics (Amitryptiline 25-75 mg OD, Prednisolone 5mg
BD – 10 mg/day) were added to step 2. Step 2 non responders were treated with step3 protocol. In step 3, tab morphine (10 mg
BD upto maximum 30 mg BD) was given after stopping all other drugs . After 48 hrs, scores were re evaluated; if scores remained
>4; adjuvant analgesics ( Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day ) were added. After 48 hrs if still pain
scores did not decrease to
Keyword :
Cancer cervix , Pain , Treatment.