Hypodermoclysis for the administration of fluids and narcotic analgesics in patients with advanced cancer.

Abstract

Fifty-eight consecutive patients with advanced cancer who required parenteral hydration were treated with hypodermoclysis. A solution of two-thirds 5% dextrose and one-third saline was used in all cases at a rate of 20-100 cc/hr, with 750 units of hyaluronidase per liter, and 20-40 mEq KCl/L were administered in all patients. In 38 patients, morphine (21 cases) or hydromorphone (17 cases) were added. The mean duration of infusion and volume were 14 +/- 9 days and 1.3 +/- 0.8 L/day, respectively (range, 0.5-3 L/day). Mean dose of KCl was 25 +/- 8 mEq/L. The reason for discontinuation was death in 43 cases, oral hydration in 12 cases, and need for fluid restriction in 3 cases. Toxicity consisted in local infection in two cases and bruising in two cases. We conclude that hypodermoclysis is a safe and effective method of hydration in patients with advanced cancer.