ORIGINAL RESEARCH article
Front. Pain Res.
Sec. Cancer Pain
Patient-Controlled Subcutaneous Analgesia with Hydromorphone in Cancer Pain Management
Provisionally accepted
Zhongkai Wang1
Pengqing Jiao2*- 1Department of Pain Medicine and Rehabilitation, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- 2Department of Rheumatology and Immunology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Background: Cancer pain is a significant public health concern worldwide, nec essitating effective management strategies. This study aimed to explore the effe cts of patient-controlled subcutaneous analgesia (PCSA) with hydromorphone hy drochloride injection on refractory cancer pain. Methods: We conducted a retrospective observational study involving patients who received PCSA with hydromorphone hydrochloride injection at our hospital from December 2022 to May 2023. All patients in this study were initially hospitalized to undergo dose titration and safety assessment for subcutaneous hydromorphone PCSA, ensuring drug tolerance and stable pump operation. After achieving dose stabilization, most patients continued analgesic therapy at home using the pump, with dynamic monitoring and dose adjustments conducted via telephone follow-ups and outpatient visits.Pain was assessed using the numerical rating scale (NRS), while anxiety and depression were evaluated using the Edmonton Symptom Assessment Scale (ESAS-R) and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). The incidence of adverse drug reactions was also documented. Results: The treatment demonstrated significant improvement across all observe d parameters.After the continuous subcutaneous injection of hydromorphone hyd rochloride infusion for analgesia,the median NRS pain score decreased from 6 to 1 (p < 0.0001), the mean sleep quality score decreased from 13.85 to 7.488 (p < 0.0001), the median anxiety state score decreased from 5 to 1 (p < 0.00 01), the median depression score decreased from a baseline of 3 to 0.5 (p < 0. 0001), and the median equivalent oral morphine dose decreased from 140 mg t o 52 mg (p < 0.0001). Conclusions: PCSA with hydromorphone hydrochloride injection offers significant therapeutic benefits for refractory cancer pain.It effectively reduces pain intensity, decreases opioid dosage, mitigates certain adverse reactions, and is associated with reduced anxiety and depression as well as improved sleep quality.
Keywords: Hydromorphone, hydrochloride, Injection, Subcutaneous, Refractory cancer pain, Pain score, Anxiety, Depression
Received: 21 Nov 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 Wang and Jiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pengqing Jiao
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