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J Pain Symptom Manage. 2013 Oct;46(4):474-82. doi: 10.1016/j.jpainsymman.2012.10.232. Epub 2013 Mar 13.

Caffeine as an adjuvant therapy to opioids in cancer pain: a randomized, double-blind, placebo-controlled trial.

Author information

  • 1Department of Medicine, Dongguk University, Seoul, Korea; Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Korea. Electronic address: lisasuhmd@hotmail.com.

Abstract

CONTEXT:

Opioid therapy often shows insufficient efficacy and substantial adverse events in patients with advanced cancer.

OBJECTIVES:

To assess the efficacy of caffeine infusion as an adjuvant analgesic to opioid therapy in patients with advanced cancer.

METHODS:

A double-blind, randomized, placebo-controlled trial was conducted in the palliative care wards of two teaching hospitals in South Korea. A total of 20 of 41 participants were assigned to the caffeine group and 21 to the placebo group. The participants received caffeine (200mg) or normal saline intravenously once a day for two days. The primary outcome was pain, which was measured using a 10-point rating scale. Other outcomes included drowsiness, confusion, nausea, sleep disturbance, fatigue, and sadness.

RESULTS:

Three participants (two in the caffeine group and one in the placebo group) dropped out after the first intervention because of insomnia; thus, 38 participants completed the trial. Pain score was significantly lower in the caffeine group than in the placebo group after the second trial (P=0.038). The mean reduction in pain intensity in the caffeine group was 0.833 (95% confidence interval [CI] 0.601-1.066), whereas that in the placebo group was 0.350 (95% CI 0.168-0.532). Considering an improvement higher than 30% from baseline as the threshold value, drowsiness improved significantly in the caffeine group after the first trial (P=0.041). Adverse event rate did not differ between the two groups.

CONCLUSION:

Caffeine infusion significantly reduced pain and drowsiness, but the reduction did not reach clinical significance in patients with advanced cancer undergoing opioid therapy. Further investigations are warranted.

Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Caffeine; cancer pain; opioid therapy; randomized controlled trial

PMID:
23498965
[PubMed - indexed for MEDLINE]
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