Journal of pain and symptom management
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J Pain Symptom Manage · Apr 1994
Case ReportsIntrathecal morphine and bupivacaine in advanced cancer pain patients implanted at home.
Fifteen patients with pain due to advanced cancer who no longer obtained relief from conventional treatment using oral or parenteral opioids were administered morphine and bupivacaine by continuous intrathecal infusion. Thirteen patients were implanted at home due to poor medical condition or refusal to be hospitalized. ⋯ Only minor side effects were evidenced. Implantation at home of an intrathecal catheter to administer morphine and bupivacaine provided a degree of pain relief during the last days of life that would have otherwise been impossible and did so without producing important complications.
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Liability issues associated with pain management are important to health-care providers, patients, pharmaceutical companies, manufacturers of pain-management devices, health-care payors, and society at large. This article discusses five specific legal liability concerns: (a) health-care providers' liability to patients and/or exposure to professional discipline for inappropriate pain management, (b) health-care providers' liability to third parties for injury caused by patients treated for pain, (c) the legal distinction between pain management and euthanasia or physician-assisted suicide, (d) health-care payors' liability to patients for cost-containment decisions that impact on pain management, and (e) manufacturers' and health-care providers' liability for the risks and side effects of prescription drugs and pain-management devices.
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J Pain Symptom Manage · Apr 1994
Randomized Controlled Trial Clinical TrialEffect of intraoperative ketorolac on postanesthesia care unit comfort.
The efficacy of intraoperatively administered ketorolac for the prophylactic treatment of pain in the postanesthesia care unit (PACU) was examined in a prospective, double-blinded study. Thirty patients undergoing general anesthesia for orthopedic or lower abdominal surgery were randomized into two groups. Both groups received equivalent doses of opioids intraoperatively. ⋯ The ketorolac group reported significantly lower pain scores 1 hr after PACU admission (P < 0.01). Time to PACU discharge was not different between groups. Intraoperatively administered ketorolac is an effective adjunct in the management of postoperative pain.