“LOCAL COMPLICATIONS OF PERIPHERAL INTRAVENOUS CHEMOTHERAPY – ANALYSIS IN CARCINOMA BREAST PATIENTS”

Aims: To identify and record the local reactions at the site of IV cannula in women with carcinoma breast during peripheral intravenous chemotherapy treatment. To find out the incidence of these reactions and correlations with various factors. Method- Prospective Observational Studywas done with evaluation of 559 individual peripheral intravenous chemotherapy cycles given in carcinoma breast patients from June 2013 to September 2015. Results: 1 in every 5 carcinoma breast patients receiving peripheral intravenous chemotherapy developed local complications. (20.92% in adjuvant cases and 18.55% in neoadjuvant cases). Pain followed by induration and altered skin color were the most common complications. Extravasation was present in 6.44% cases.other complications commonly noted were tingling sensation in IV applied limb, edema, thrombophlebitis, cellulitis and ulcer. IV cannula application on ipsilateral site (in limb on side of breast cancer) is associated with RR=2.08. IV cannulation over the wrist have 1.57 times (RR=1.57) and multiple puncture attempts to secure IV cannula is associated with 1.97 times (RR=1.97) more risk of developing local complications following peripheral intravenous chemotherapy. Elderly age >50yrs, small of large calibre IV cannula (no 18 G and No 24 G) have more local complications. Conclusions: Occurrence of local complications after peripheral intravenous chemotherapy in carcinoma breast patient is common. Vigorous monitoring of patient with repeated and frequent examination of site of chemotherapy cannulisation must be done during the complete chemotherapy infusion process and detailed records must be kept at every stage. A generalised chemotherapy infusion guidelines and protocol should be established according to the hospital occurrence. Active Patients participation in monitoring is advised. More multicentre studies are required to create a data base of venous damage occurring following intravenous peripheral chemotherapy and to formulate standard guidelines and protocols to reduce the rate of complications. Precaution, and care during peripheral intravenous chemotherapy can prevent development of local complications and remove the need for surgical intervention for management of the complications, thus, reduce the hospital stay, additional diagnostic procedures and treatment, stress in the life of the patients' relatives, extra work load on the health personnel and economic loss accordingly.