Journal of pain and symptom management
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Cancer pain treatment is well established. The World Health Organization provides clinicians an "analgesic ladder" scheme to optimize cancer pain treatment. At the beginning of the pain treatment, oral analgesic administration is preferred. ⋯ Based on this experience, the generally accepted indications for the technique appeared to be justified. Concern about spinal infection is well considered, however. Three out of those patients developed meningitis, a complication rate that is far too high.
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J Pain Symptom Manage · Feb 1994
Altered sexual function and decreased testosterone in patients receiving intraspinal opioids.
Altered sexual function has been reported in individuals addicted to opioids or on methadone maintenance, yet little literature is available regarding the effect of intraspinal opioids on libido or sex hormone levels. We evaluated sexual function and plasma sex hormone levels in six men treated with chronic intraspinal opioids. All patients had some reduction in libido and four patients had difficulty obtaining or maintaining an erection. ⋯ Serum testosterone levels and other sex hormones, including follicle-stimulating hormone, luteinizing hormone, sex-hormone-binding globulin, and prolactin, should be measured prior to and at various points during intraspinal opioid therapy. Patients should be queried regarding sexual function and should be cautioned regarding the possibility of these adverse effects prior to initiating spinal opioids. Supplemental testosterone should be considered to treat this dysfunction.
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J Pain Symptom Manage · Jan 1994
Assessment of patient satisfaction utilizing the American Pain Society's Quality Assurance Standards on acute and cancer-related pain.
An evaluation of patient satisfaction with pain management is one component of a total quality assurance program on pain management recommended by the American Pain Society. This study utilized the patient satisfaction survey recommended by the Quality Assurance Committee of the American Pain Society and was conducted in an acute care, municipal hospital. ⋯ Data from the survey suggest that while patients experienced moderate-to-severe pain and had to wait relatively long periods of time for pain medications, in most cases they were satisfied with their overall pain management. Recommendations for conducting patient satisfaction surveys of pain management in acute care settings are reviewed, and methods for interpreting data from these types of surveys are discussed.
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The purpose of this study was to assess older adults to determine (a) the course of postoperative pain, (b) influences of pain and analgesics on mental status, and (c) relationships among age, mental status and pain. Sixty adults, aged 50-80 yr, who had total hip replacement surgery were included in this study. All subjects had met a preoperative criterion for mental status. ⋯ Age was not related to pain or mental status. In general, pain was poorly managed in this group of subjects. The results suggest an explanation for acute confusion in older patients after surgery and recommend improved pain management.
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J Pain Symptom Manage · Nov 1993
Use of the Edmonton Injector for parenteral opioid management of cancer pain: a study of 100 consecutive patients.
In this retrospective study, we reviewed the patterns of use of the Edmonton Injector (EI) in 100 consecutive cancer patients. Seventy-eight patients used the EI for an average of 23 +/- 27 days. The main reasons for starting the EI were nausea (37 patients) and severe pain (31 patients). ⋯ The average cost of treatment was $1.65 Canadian per patient per day. No mechanical problems or refusals to start or continue treatment were detected. We conclude that the EI is a safe and simple device that allows for cost-effective parenteral administration of opioids for cancer pain.