Articles: pain.
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Cancer Chemother. Pharmacol. · Jan 1982
Randomized Controlled Trial Clinical TrialA double-blind controlled trial of salmon calcitonin in pain due to malignancy.
Thirty-two patients with established malignancy and associated pain participated in a randomised double-blind controlled trial. They received salmon calcitonin SC 200 UI or matching placebo 6-hourly for 48 h and were assessed by using a combination of a 20-point visual analogue scale (VAS), a 4-point physician's global pain scale, and ranking of the co-administered analgesics into 20 grades of potency. ⋯ One week after commencing therapy there was improvement or marked improvement of pain in significantly more patients in the calcitonin group (5/13) than in the placebo group (0/12) (Fisher's exact two-tailed probability test, P = 0.0484). At the end of the second week three patients in the calcitonin group were still showing marked improvement.
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Journal of medicine · Jan 1982
Comparative StudyUse of intrathecal and epidural morphine for pain relief in patients with malignant diseases: a preliminary report.
The results of a preliminary study involving the treatment of various malignant pain disorders by intrathecal (I. T.) or epidural (E) morphine sulfate (M. ⋯ The overall duration of pain relief was modest and ranged from 10 to 72 hours; the intrathecal route provided a slightly longer duration (median: 48 hours; range: 15-72 hours) of analgesia than that of the epidural route (median: 20 hours; range: 10-72 hours). Minor and transient complications occurred in 10 (55%) patients.
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Long-term treatment for malignant pain with morphine epidurally poses some technical problems: infection and contamination of epidural space, fixation of the epidural cannula, personal hygiene of the patient, etc. We suggest that a solution to these problems is subcutaneous tunnelling of the epidural cannula. This paper describes our technique and presents the case histories of two patients. In one case, a single epidural cannula was used for 207 days for treatment with morphine epidurally without any complication.
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Acta Anaesthesiol Scand Suppl · Jan 1982
Pain treatment in a palliative unit or team of a university hospital.
A Palliative Care Unit and Team provides a model for delivering care, in which narcotic analgesics can be optimally effective in the treatment of cancer pain. Our rapidly expanding knowledge of pain physiology and narcotic pharmacokinetics will not benefit patients unless we design more appropriate organizational structures to implement therapy and to teach symptom control. The Palliative Care Service model, as developed at several university hospitals in Canada, is designed to assist and complement oncology departments. ⋯ Hospital organization must reflect the fact that environmental and psychosocial factors alter pain perception and response. Oral morphine is more effective when administered in a Palliative Care Unit than when it is given to patients in other settings. The Unit provides personnel skilled in analgesic titration and a supportive environment in which psychological, social and spiritual components of the pain experience can be evaluated and treated.