Disease introduction
Palliative Care
A major goal of palliative care is comfort, and care at the end of life should be responsive to the personal needs and preferences of the patient. The subcutaneous (SC) route has become a favored route of administration in palliative care due to its flexibility, safety and practicality.1 The SC route is particularly useful for patients with dysphagia, nausea and vomiting, or bowel obstruction.2,3
Infusion Therapy
Best practice in pain management is to use the least invasive route of administration for the prescribed opioid. Due to this, in most cases patients are introduced to opioid pain management in a short acting formulation that is taken orally.4 However, if the pain continues, or in cases of severe pain, patients may be prescribed stronger opioids by oral administration. If patients are unable to take medication orally, then opioids may be administered by injection or continuous infusion. Subcutaneous infusion of opioids is considered preferable, as it is less invasive and may be better tolerated than intravenous infusion and less painful than intramuscular injection.
neria™ infusion sets for Pain Management and Palliative Care
Relief and comfort are key focal points in pain management, especially in palliative care. Therefore, the soft cannula range of neria infusion sets are frequently recommended for infusions. These infusion sets have a disconnect feature which make them convenient to use during long infusion periods.
In general, however, the choice of infusion set should always be based on the health care professional’s assessment of each individual patient’s situation.
neria™ infusion sets have been tested for safe use with hydromorphone, morphine sulfate and morphine chloride for pain management.5
1.Kestenbaum MG et al. Alternative routes to oral opioid administration in palliative care: a review and clinical summary. Pain Medicine 2014;15:1129-1153, 2. Mercadante S et al. Alternatives to oral opioids for cancer pain. Oncology 1999;13:215-25, 3. Anderson SL et al. Continuous subcutaneous infusion of opiates at end-of-life. Ann Pharmacother 2004;38:1015-23, 4. WHO web site, www.who.int/cancer/palliative/painladder/en/, 5. Statement - Overview of Drug/Device Compatibility Test for the neria™ Range. 24. February 2020. AP-020446-MM. Data on file. Unomedical A/S.
Needle safety & neria™ Infusion Sets
The importance of preventing needle stick injuries is emphasized in guidelines and procedures for healthcare workers all over the world. Preventing needle stick injuries has huge advantages for health care workers and reduces the cost of treatment in hospitals, elderly homes and general practices.1
Our brochure on needle stick injuries discusses the consequences of needle stick injuries and the advantages of needle safety devices.
neria™ guard is the only device on the market that offers a fully automatic insertion technique for safe and needle free operation. Learn more about the neria™ guard under "Training and Education".
1. Costigliola V, Frid A, Letondeur C, Strauss K. Needlestick injuries in European nurses in diabetes. Diabetes Metab. 2012;38(Suppl 1):S9–S14.
The neria product range
neria™ infusion sets have been tested for safe use with hydromorphone, morphine sulfate and morphine chloride for pain management and palliative care.1
The neria product range offers a wide range of infusion sets with different features to help support the best possible treatment for pain management and palliative care.
For a complete overview of our neria™ infusion set range, including specifications, please see the table below. The table is also available as a pdf download.
| Product Specifications | neria™ | neria™ detach | neria™ multi | neria™ soft | neria™ soft 90 | neria™ guard |
|---|---|---|---|---|---|---|
| Cannula | Stainless Steel | Stainless Steel | Stainless Steel | Soft | Soft | Soft |
| Insertion angle | 90 degrees | 90 degrees | 90 degrees | 20-45 degrees | 90 degrees | 90 degrees |
| Disconnection feature | No | Yes | No | Yes at site | Yes at site | Yes at site |
| Needle / Introducer needle guage | G27 or G29 | G27 | G27 | G27 | G27 | G27 |
| Needle lengths | 6, 8 10 or 12 mm | 6,8 or 10mm | Bi-furcated: 8, 10mm Tri-furcated: 8, 10 or 12mm Quad-furcated: 8, 10, 12mm |
13 or 17mm | 6 or 9 mm | 6 or 9 mm |
| Tubing lengths | 60, 80, 110 cm | 60, 80, 110 cm | Total 90 cm | 30, 60, 80, 110 cm | 30, 60, 110 cm | 12, 30, 60, 80, 110 cm |
| Adhesive | Built-in | Built-in | Built-in | Built-in | Built-in | Built-in |
| Needle safety | - | - | - | - | Yes | Yes |
| Priming volumes | 60 cm @ 0.10 ml 80 cm @ 0.12 ml 110 cm @ 0.15 ml |
60 cm @ 0.10 ml 80 cm @ 0.12 ml 110 cm @ 0.15 ml |
Bi-furcated ~ 0.36 ml Tri-furcated ~ 0.43 ml Quad-furcated ~ 0.51 ml |
30 cm @ 0.06 ml 60 cm @ 0.10 ml 80 cm @ 0.12 ml 110 cm @ 0.15 ml |
30 cm @ 0.06 ml 60 cm @ 0.10 ml 110 cm @ 0.15 ml |
12 cm @ 0.04 ml 60 cm @ 0.10 ml 80 cm @ 0.12 ml 110 cm @ 0.15 ml |
1. Statement - Overview of Drug/Device Compatibility Test for the neria™ Range. 24. February 2020. AP-020446-MM. Data on file. Unomedical A/S.
Resources
Find relevant clinical literature about continuous subcutaneous infusion management in palliative care and pain management below:
- Subcutaneous Administration of Drugs in Palliative Care: Results of a Systematic Observational Study
Lena Bartz, Carsten Klein, MD, Andreas Seifert, Prof Dr, Iris Herget, Christoph Ostgathe, MD, and Stephanie Stiel, Dipl Psych
J Pain Symptom Manage 2014; 48: 540-547
Tabitha Thomas, Stephen Barclay
int J Palliat Nurs. 2015 Feb;21(2):60
Sue Healy, Fiona Israel, Margaret Charles, Liz Reymond
Palliative Med. 2018 Jul;32(7):1208-1215.
Matthew G Kestenbaum, Agustin O Vilches, Stephanie Messersmith, Stephen R Connor, Perry G Fine, Brian Murphy, Malene Davis, J Cameron Muir
Pain Med. 2014 Jul;15(7):1129-53
Catherine E Cooke, Jennifer M Stephens
Medical Devices: Evidence and Research 2017:10 225–235
Andrew Dickman & Jennifer Schneider
“A continuous subcutaneous infusion (CSCI) provides a safe and effective way of drug administration and can be used to maintain symptom control in patients who are no longer able to take oral medication. The syringe driver is a simple and cost-effective method of delivering a CSCI. This book serves as a valuable reference source, providing comprehensive review of syringe driver use and administration of drugs via CSCI.”
