Dexmedetomidine Addition to Morphine in Patients With Metastatic Cancer

Inclusion Criteria:

• Any painful patient with metastatic cancer
• Whatever type of pain: nociceptive, neuropathic, or mixed
• Age > 18 and <75 years
• Patient under analgesic Tier III treatment: with moderate to severe pain and not relieved by non-opioid conventional treatment
• Patient cooperating capable of responding to the pain assessment by providing a number from 0 to 10 at the VAS
• Patient providing his explicit consent to participate in the study before inclusion (regardless of his inclusion in C or D Group)
• Patients with systolic blood pressure (SBP) ≥ 100 mmHg and a diastolic blood pressure (DBP) ≥ 50 mmHg
• Patients with a heart rate ≥ 50/min

Exclusion Criteria:

• Patient refusal to participate in the study or patient unable to give consent
• Age <18 or > 75 years
• Comatose uncooperative patient unable to respond to the assessment of pain by VAS
• Hypotensive patients with SBP < 100 mmHg and DBP < 60 mmHg or bradycardic with a heart rate < 50/min
• Patient with a heart rhythm disorder, or a disorder of the atrial-ventricular conduction
• Patients under beta-blocker
• Patient with heart failure with an ejection fraction < 40%
• Patient suffering from allergy or previous intolerance to morphine or dexmedetomidine
• Patient with renal impairment with a creatinine clearance <3 0ml/min/1.73m2, or patient under hemodialysis or peritoneal dialysis.
• Patient with severe hepatic impairment with Child-Pugh score at C.