pain-relief-22.matches: pain relief
Half body irradiation for palliation of widespread metastatic bone disease.

Chua ET, Chua EJ, Sethi VK.

Department of Therapeutic Radiology, Singapore General Hospital.

An analysis is made of 134 patients treated by a single dose half body irradiation at the Department of Therapeutic Radiology, Singapore General Hospital. A total of 149 fields were treated with 15 patients receiving both upper and lower half treatments. This technique achieved a more than 70% subjective pain relief in the patients who had widespread bony metastases. Side effects were minimal and this technique has been used on an outpatient basis since the first preliminary study in 1986. There was a dose response, more than 75% (75 out of 97 patients) with pain relief using doses of 700 cGy and above. Sensitive tumours also produced better results with nasopharyngeal carcinoma, prostate and breast having pain relief in more than 70% of patients. The largest group of patients (51 cases) treated was nasopharyngeal carcinoma, as this tumour is fairly common locally and often presents with bony metastases as the first site of spread.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7521611&dopt=Abstract pain, pain medicine, pain relief



pain-relief-22.matches: pain relief
Development of cancer pain relief and palliative care in the Philippines.

Laudico AV.

University of Philippines.

The article describes the development and progress of cancer pain relief and palliative care in the Philippines from 1986 onwards. The strategy employed was a stepwise progression that began with the establishment of government policy, followed by measures to improve availability and accessibility to oral morphine, and finally, continuing nationwide professional education. Key elements to successful implementation were the presence of a national cancer control programme; the active participation of the World Health Organization, the Department of Health, the Philippine College of Surgeons, and the Philippine Cancer Society Inc; and research development and utilisation. Data from three clinical studies are also presented, which showed the efficacy of the WHO Method of Cancer Pain Relief among samples of Philippine patients, and that cancer pain relief alone did not significantly improve overall quality of life, demonstrating the need for comprehensive palliative care.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7521621&dopt=Abstract pain, pain medicine, pain relief



pain-relief-22.matches: pain relief
The Oncology Nursing Society: commitment and activities promoting cancer pain relief.

Spross JA, Moore P.

Oncology Nursing Society, Pittsburgh, Pennsylvania 15220-2749.

The primary mission of the ONS is promoting excellence in oncology nursing. In its efforts to accomplish this mission, the undertreatment of cancer pain has emerged as a significant issue for clinicians, educators, researchers, and administrators involved in the care of people with cancer. In an effort to promote cancer pain relief, the ONS contributes human, administrative, and financial resources from its existing organizational structure, personnel, and volunteers in the variety of ways described above. The structure of the ONS enables it to support the goal of cancer pain relief from the broadest of policy-making activities nationally to the provision of care by a nurse to a patient and family. The ONS Position Paper on Cancer Pain, other position papers and statements, adopted resolutions, and the strategic planning process will continue to guide the ONS's commitment and contributions to promoting cancer pain relief.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7525755&dopt=Abstract pain, pain medicine, pain relief



pain-relief-22.matches: pain relief
[Continuous intrathecal analgesia in terminal cancer patients within transmural health care]

[Article in Dutch]

Wagemans MF, Spoelder EM, Zuurmond WW, de Lange JJ.

Academisch Ziekenhuis Vrije Universiteit, afd. Anesthesiologie, Amsterdam.

OBJECTIVE. To record the daily morphine doses, the influence of the treatment on quality of life and the incidence of side-effects and complications of continuous intrathecal morphine administration. SETTING. Academic Hospital, Free University, Amsterdam. DESIGN. Prospective. METHODS. Forty terminal patients with intractable cancer pain, who had either insufficient pain relief or severe side effects from systemic analgesics were selected for continuous intrathecal administration of morphine. An intrathecal catheter was implanted, tunnelled and connected with a portable infusion pump delivering morphine constantly and if needed on demand. In a pain diary the patients recorded: the number of daily doses of morphine, concomitant medication, pain scores on a visual analogue scale (VAS), extra doses and activities. RESULTS. The total number of catheter days was 1486. Patients were treated for a mean of 37.2 (range 2-183) days. The mean dose of daily administered morphine was in 30 patients (75%) less than 20 mg. Sufficient pain relief (VAS score < 5) was achieved in 37 patients (92.5%). Three patients had pain due to spinal cord compression, hardly responding to intrathecal morphine. Withdrawal symptoms, post-puncture headache and leakage of fluid could been treated conservatively. The catheter was removed inadvertently 6 times and could be replaced on outpatient basis. Meningitis occurred in 2 patients, who were adequately treated with antibiotics. The catheter could be re-inserted within 10 days. CONCLUSION. In terminally ill cancer patients, the continuous intrathecal administration of morphine may be recommended if conventional pain relief fails.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7690112&dopt=Abstract pain, pain medicine, pain relief



pain-relief-22.matches: pain relief
Interpleural analgesia for postoperative pain relief in renal surgery patients.

Kaukinen S, Kaukinen L, Kataja J, Karkkainen S, Heikkinen A.

Department of Anaesthesiology, Tampere University Hospital, Finland.

The feasibility of interpleural analgesia for postoperative pain relief after renal surgery using anterior intercostal incision was studied in 16 adult patients. 20 ml bupivacaine plain 5 mg/ml in ten patients, and the same dose of bupivacaine with epinephrine 5 micrograms/ml in six patients, was injected through epidural catheter into the pleural space of the operated side, maximally three times per 24 hours. As additional pain medication, oxycodone i.m. was given if needed. In ten control patients, oxycodone was the only pain medication. Postoperative pain relief in patients who received interpleural bupivacaine plain was excellent in four, moderate in four and poor in two cases. For supplemental pain relief the patients were given 2.1 +/- 1.1 (SEM) injections of oxycodone during the three days. Control patients received, respectively. 11.6 +/- 0.7 injections of oxycodone, and they considered the pain relief excellent in six and moderate in four cases. Median duration of interpleural analgesia was in bupivacaine plain cases 6 h (range 2-14 h) and in bupivacaine with epinephrine 7 h (range 4-15 h). The mean peak serum concentration of bupivacaine plain was 1868 +/- 168 ng/ml, and that of bupivacaine with epinephrine 1312 +/- 273 ng/ml. No complications were seen. The results suggest that interpleural analgesia obtained by 20 ml bupivacaine 5 mg/ml three times a day gives most patients good pain relief.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8009191&dopt=Abstract pain, pain medicine, pain relief



pain-relief-22.matches: pain relief
Retrospective investigation of intermittent bolus intrathecal morphine for cancer pain patients.

Cheng KI, Tang CS, Chu KS, Yip NS, Yu KL, Tseng CK.

Department of Anesthesiology, Kaohsiung Medical College, Taiwan, Republic of China.

One hundred patients with intolerable cancer pain were treated with intrathecal bolus injections of morphine(IT morphine). The study began 2 days later after port-A cath implantation and continued during the 12 weeks follow-up period. During the investigation, the dosages, pain intensity, side effects, complications, activity and acceptibility were recorded. Initially, the morphine test does(0.2mg) resulted in pain relief for 8-26 hrs (mean 13.4 hrs). Then, changing the morphine dosages or frequency of injections were relied upon the effect of the opiate to provide 24 hrs pain relief. The mean morphine requirements were 0.32mg in 1st week, 0.44mg in 4th week, 1.25mg in 8th week and 1.43mg in 12th week. The mean morphine dose before IT treatment was 36.4mg. The vast majority of patients' pain intensity decreased prominently after IT morphine treatment. But pain was aggravated in the 12th week although the morphine dose increased. Side effects were minimal, and only one patient suffered from meningitis. Complications included 8 patients with port-A system dysfunction, one with anterior spinal artery syndrome, and one case of cauda equina syndrome. Activity improved significantly and all patients accepted the kind of treatment though some patients did not experience completely satisfactory relief from pain. Intrathecal morphine therapy uses only small amounts of opiate to achieve the optimal level of pain relief. So it offers a beneficial treatment option to patients whose pain has become intolerable or who have poor responsiveness to systemic narcotics.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8046782&dopt=Abstract pain, pain medicine, pain relief



pain-relief-22.matches: pain relief
Pain relief mediated by implantable drug delivery devices.

Hoekstra A.

Centre for Biomedical Technology, Faculty of Medicine, University of Groningen, The Netherlands.

Various totally implantable drug delivery systems from single access ports to micropumps are now available for administration of repeated boluses, and continuous or programmable infusions. In this respect, emphasis is given to a relatively cheap, totally implantable system for self-administering intraspinal opiates in the treatment of cancer pain. The SECOR pump system, developed by Cordis, consists of a dual pump with refill port and safety valve. The volume of the pliable reservoir is 12 ml and refill is accomplished with a 25-G needle. The bolus delivered with each transcutaneous activation of the pumps is 0.1 ml. Clinical results demonstrated that this patient-controlled drug delivery system is safe and provides excellent pain relief associated with terminal cancer. A possible advantage of this drug delivery system over continuous infusion pumps is that patients can elect to have the morphine delivered only when they feel pain. Thus pain relief would be maximized and tolerance build-up would be minimized.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8050806&dopt=Abstract pain, pain medicine, pain relief