Articles: palliative-care.
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Palliative medicine · Jan 1994
Case ReportsSuccessful use of methadone in nociceptive cancer pain unresponsive to morphine.
Morphine is the mainstay of pain control in cancer patients. We describe three patients in whom adequate analgesia was not obtained with morphine, and discuss the role of morphine metabolites and the use of methadone as an alternative strong opioid analgesic.
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During the last 10 years interest in palliative care research has grown. This interest has brought about an awareness of the unique ethical issues related to research in this special population. Issues related to the vulnerability of patients and families, consent protocols, unstable mental status, and the invasiveness of assessments have been discussed. ⋯ However, until now, administrators, governments, and clinicians have planned palliative care programs to have only service and some teaching components. And traditional research-sponsoring agencies have not allocated priority to palliative care in their funding strategies. The palliative care community must take the initiative in this debate.
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Palliative medicine · Jan 1994
Safety and efficacy of nebulized lignocaine in patients with cancer and breathlessness.
Although anecdotal reports suggest nebulized lignocaine may help breathlessness in patients with cancer this has not been examined formally. We report a pilot study comparing nebulized lignocaine 100 mg and 200 mg with saline in six patients with cancer who were breathless at rest. ⋯ The effort of breathing (measured on a visual analogue scale) did not differ between treatments, whereas the distress of breathing was less after saline than after either dose of lignocaine. These findings do not support the reported benefits of nebulized lignocaine.