- Joined
- Apr 10, 2007
- Messages
- 101
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I'm recently out of fellowship where we did all our pump trials as inpatient admits.
I'm getting my first metastatic prostate Ca patient in this week, and I'm interested in getting a pump into him sooner rather than later.
I am really trying to avoid putting this guy in the hospital anymore than he needs - he was just there with COPD issues last week, and doesnt need HAP or MRSA or other complications.
In my view, if he responds to po opioids he will respond to IT opiods, but its the logistics of the trial I'm trying to work out.
Anyone here do single-shot fentanyl trials in the office? How long do you keep them before sending them home. I don't feel comfortable doing IT morphine and sending him home.
Do you have them hold or titrate down current meds before the trial?
I was thinking of 100mcg fentanyl, watch for about 2 hours, then home. I am aware of CMS catheter requirements for pump trials....so maybe a CSE and thread the catheter, then pull before sending home.
Since I don't have any experience with the in-office approach, I'm open to suggestions.
I'm getting my first metastatic prostate Ca patient in this week, and I'm interested in getting a pump into him sooner rather than later.
I am really trying to avoid putting this guy in the hospital anymore than he needs - he was just there with COPD issues last week, and doesnt need HAP or MRSA or other complications.
In my view, if he responds to po opioids he will respond to IT opiods, but its the logistics of the trial I'm trying to work out.
Anyone here do single-shot fentanyl trials in the office? How long do you keep them before sending them home. I don't feel comfortable doing IT morphine and sending him home.
Do you have them hold or titrate down current meds before the trial?
I was thinking of 100mcg fentanyl, watch for about 2 hours, then home. I am aware of CMS catheter requirements for pump trials....so maybe a CSE and thread the catheter, then pull before sending home.
Since I don't have any experience with the in-office approach, I'm open to suggestions.