Use of opioids and its impact on quality of life in chemotherapy induced oral mucositis: A prospective observational study 
Authors: S. Mishra1, R. Nandi2, V. Pratap Singh3, A. Sharma4, L. Kumar5, S. Bhatnagar6. 
Institutions: 1, 2, 3, 6  Department of Onco-Anaesthesia And Palliative Medicine, IRCH- AIIMS- Ansari Nagar, New Delhi, India. 
4, 5  Medical Oncology, IRCH- AIIMS- Ansari Nagar- New Delhi- INDIA. 
Introduction: 
Oral mucositis, a progressive, inflammatory, and ulcerative condition of the mucous membranes and it is one of the common side effects of cancer treatment. Primary objective of this study to was to evaluate requirement of opioids for chemotherapy induced oral mucositis 
Methods: 
It was a prospective, non-interventional single -centre observational study. The cancer patients who had developed chemotherapy induced mucositis requiring intravenous opioid requirement for symptom control were included in the study. Oral mucositis with the WHO oral mucositis grading, pain, the performance status, opioid requirement and quality of life using EORTC QOL- C30 
questionnaires were assessed. Chemotherapy received were also noted. Patients were followed up for 7 days after initiation of intravenous opioid administration 
Results: 
Total 100 patients were included in the study. 61% patients were male. Mean performance status of the patients with KPS scale was 57%.. Average gap of development of mucositis and last dose of chemotherapy was 6.7 days. 84% of the patients were managed with IV morphine administration initially. As the time passes eventually total 93% patients required morphine administration for symptom control. Mean intravenous morphine consumption was 26 mg in 1stday of presentation. Median WHO grading of mucositis was 3.Global health status, physical functioning, role functioning, emotional functioning, cognitive functioning and social functioning were improved on day 7 in comparison to day 1. 
Conclusions: 
Chemotherapy induced mucositis often require strong opioids like morphine administration for symptom control. Initial intravenous morphine consumption can be as high as 26 mg per day.

USE OF OPIOIDS AND ITS IMPACT ON QUALITY OF LIFE IN CHEMOTHERAPY INDUCED ORAL MUCOSITIS: A PROSPECTIVE OBSERVATIONAL STUDY