TREATMENT OF PAIN IN CHRONIC BOWEL SUBOBSTRUCTION WITH SELF-ADMINISTRATION OF METHADONE

Chronic treatment with opioids in cancer patients with chronic intesti nal obstruction is hazardous, as uncontrolled constipation may result in definitive bowel obstruction, Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opi oid doses that will have sufficient effect, with a consequently lower risk of intestinal side effects, Methadone has many pharmacokinetic ch aracteristics that fit it for use in this clinical situation. In two p atients with recurrent episodes of bowel obstruction, methadone used a t low doses and at flexible intervals regulated by the patients accord ing to their pain level avoided the occurrence of new episodes of inte stinal obstruction, Oral patient-controlled analgesia with methadone m ay be a simple, safe and cheap method of treating patients with pain a ssociated with subtotal intestinal obstruction.