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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Management of the chronic pain of cancer is a common and difficult problem. In addition to a medical examination of the patient, it is necessary to perform a psychological assessment of his premorbid personality, current mental status, and coping mechanisms to devise an individualized approach to his pain. The mainstay of cancer pain control are the narcotics, which differ primarily in potency and duration of action. Nonnarcotic analgesics are equianalgesic with the less potent narcotics. Antipsychotic drugs are useful as tranquilizers, antiemetics, and analgesic potentiators. Antidepressants and hypnotics permit the patient a more normal life-style. Stimulants such as cocaine and amphetamines both potentiate narcotic analgesia and reduce narcotic-induced somnolence and respiratory depression. Tetrahydrocannabinol offers no advantage over traditional analgesics. With care and patience, the physician can render practically any cancer patient pain-free.
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PMID:Medical management of chronic cancer pain. 3 26

Evaluation of the analgesic activity of indoprofen was carried out in patients with cancer pain under double-blind conditions and compared with aspirin and placebo. A randomized experimental design was followed. Single oral doses were given of the test drug (100 and 200 mg), aspirin (600 and 1,000 mg), and placebo. For measuring analgesia, 5-point pain intensity and pain relief semiquantitative scales were used. Potency ratio between drugs was calculated on SPID (sum of pain intensity differences) and TOTPAR (total pain relief) and resulted in 10.3 by combination of estimates. In a group of only 24 patients, the data supported the following conclusions: indoprofen at 100 and 200 mg single doses is effective in relieving cancer pain; it displays a dose-related analgesic effect comparable to that of aspirin with only one-tenth the dose.
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PMID:Indoprofen, a new analgesic and anti-inflammatory drug in cancer pain. 4 81

Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in three hospital environments: a palliative care unit (PCU), general wards and private rooms. Pain was measured in 92 patients with the McGill-Melzack Pain Questionnaire. The Brompton mixture controlled pain in 90% of patients in the PCU and in 75% to 80% of patients in the wards or private rooms. The differences in pain scores between the PCU patients and the other groups were significant. The mixture produced substantial decreases in the three major dimensions of pain: sensory, affective and evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.
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PMID:The Brompton mixture: effects on pain in cancer patients. 5 10

The Brompton mixture is a highly effective, flexible, safe and convenient means to control chronic pain of malignant disease. The mixture is a solution containing morphine, the dose of narcotic varying with the need for analgesia, and is given regularly, usually every 4 hours, with a phenothiazine. The main aims of therapy are prevention of pain rather than treatment, an unclouded sensorium and a normal effect. Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in 3 hospital environments: 1) a palliative care unit, 2) general wards and 3) private rooms. Pain was measured in 92 patients with the McGill-Melzack pain questionnaire. The Brompton mixture controlled pain in 90 per cent of patients in the palliative care unit and in 75 to 80 per cent of patients in the wards or private rooms. The differences in pain scores between patients in the palliative care unit and the other groups were significant. The mixture produced substantial decreases in the 3 major dimensions of pain: 1) sensory, 2) affective and 3) evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.
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PMID:The management of intractable pain in patients with advanced malignant disease. 8 92

The Brompton mixture is a highly effective, flexible, safe and convenient means to control chronic pain of malignant disease. The mixture is a solution containing morphine, the dose of narcotic varying with the need for analgesia, and is given regularly, usually every 4 hours, with a phenothiazine. The main aims of therapy are prevention of pain rather than treatment, an unclouded sensorium and a normal effect. Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in 3 hospital environments: 1) a palliative care unit, 2) general wards and 3) private rooms. Pain was measured in 92 patients with the McGill-Melzack pain questionnaire. The Brompton mixture controlled pain in 90 per cent of patients in the palliative care unit and in 75 to 80 per cent of patients in the wards or private rooms. The differences in pain scores between patients in the palliative care unit and the other groups were significant. The mixture produced substantial decreases in the 3 major dimensions of pain: 1) sensory, 2) affective and 3) evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.
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PMID:The management of intractable pain in patients with advanced malignant disease. 8 29

We have previously reported 10 patient histories involving various intractable pain syndromes where the administration of Haloperidol either eliminated the need for narcotic analgesics or resulted in a significant reduction in narcotic dosage. We are presently undertaking a controlled double-blind evaluation of Haloperidol as an adjunctive treatment for intractable cancer pain. Based upon the reported clinical observations, these findings are discussed from the following aspects: 1. The isomeric similarity of Haloperidol to Meperidine. 2. Dose response between Haloperidol and analgesic effect. 3. The clinical literature regarding the use of Haloperidol for the effective withdrawal or maintenance of narcotic addicts. 4. The analgesic property as it relates to the opiate receptor.
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PMID:Analgesia and haloperidol: a hypothesis. 22 41

A group of 47 elderly patients with various ailments and aged between 66 and 99 years were treated with tiapride: very good results were obtained in 7 cases of severe buccofacial dyskinesia, though the dosage had to go as high as 800 mg/day; results were excellent in 2 cases, good in 9, moderate in 5, and nil in 3 out of 19 patients with agitated states; overall results were good (1 failure) in 8 cases of alcoholism (4 acute and 4 chronic); 8 good results and 4 failures were noted in 12 patients with either cancer pain, or pain following zoster or due to arthrosis or migraine. The product was very well-tolerated by these elderly patients.
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PMID:[Therapeutic advances in geriatry. A report on 47 cases (author's transl)]. 22 63

In view of negative experience and the disappointing long-term results, most of the classic surgical methods for treating chronic pain are no longer indicated. Only in cancer pain is dissection of the spino-thalamic tract at the cervical or upper thoracic level frequently helpful. In selected cases the same may be said of rhizotomy. Controlled thermocoagulation of the Gasserian ganglion provides the best results in typical trigeminal pain. Other methods of surgical treatment (e.g. commissural myelotomy, thalamotomy) mentioned in this article are things of the past which are no longer used.
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PMID:[Surgical treatment of chronic pain]. 27 7

Electrical stimulation of the periventricular and periaqueductal gray matter via a percutaneous electrode appears to be a useful method for relieving cancer pain with midline and bilateral distribution. Due to the nondestructive character and the minor surgical risks involved in this procedure it may be tried before considering bilateral cordotomy or myelotomy. A possible mechanism of action or at least a contributive factor to the pain relief is the activation of endorphins.
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PMID:Percutaneous central gray stimulation for cancer pain. 31 Feb 85

In an investigation of a new oral analgesic agent, codeine was chosen as the reference drug because of its established reputation as an effective agent for the relief of pain. Thirty-five patients with cancer pain were studied. Their average age was 58 years, During a 5-day hospital stay they received, on each of three days, either codeine (120 mg or 60 mg) or placebo. At hourly intervals after ingestion the nurse observer collected data on pain intensity and the degree of pain relief, and the patients independently charted the hourly intensity. Statistical analysis failed to show any significant superiority of either dose of codeine over placebo. Moreover, codeine is known to have a constipating effect. Re-appraisal of the value of codeine as an analgesic agent in elderly patients seems justified.
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PMID:Appraisal of codeine as an analgesic in older patients. 35 28


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