Journal of pain and symptom management
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This survey compares costs of two commonly utilized implantable narcotic delivery systems. The systems are classified into type-I (exteriorized system using the DuPen epidural catheter) and type-II (implanted system using the Synchromed pump). Costs were analyzed by reviewing actual patient hospital financial service records and Homecare vendor quotations. From the perspective of cost analysis alone, we conclude that savings accrue when patients requiring treatment beyond 3 months duration are managed with a type-II implanted system compared with a type-I system with an external pump.
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Cough is a distressing and disabling symptom in cancer patients. Based on an understanding of the physiology of the cough reflex and the pathophysiology of cough in cancer patients, a systematic approach to the management of this symptom is presented.
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J Pain Symptom Manage · Apr 1991
Clinical TrialInitial clinical experience with the SKY epidural catheter.
The new SKY epidural catheter was evaluated, based upon information collected about implant and use of 53 catheters by 51 patients. Catheters were used to treat chronic pain of a malignant (n = 25) and nonmalignant (n = 28) origin. Of 3450 treatment days, 89% occurred at home. ⋯ No subarachnoid or epidural infections occurred. The SKY catheter proved to be safe and reliable. Therapy was cost-effective, since patients achieved substantial pain relief while treated at home.
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J Pain Symptom Manage · Feb 1991
Clinical Trial Controlled Clinical TrialAuricular transcutaneous electrical nerve stimulation (TENS) reduces phantom limb pain.
The present paper evaluates the efficacy of low frequency, high intensity auricular transcutaneous electrical nerve stimulation (TENS) for the relief of phantom limb pain. Auricular TENS was compared with a no-stimulation placebo condition using a controlled crossover design in a group of amputees with (1) phantom limb pain (Group PLP), (2) nonpainful phantom limb sensations (Group PLS), and (3) no phantom limb at all (Group No PL). ⋯ Ratings of mood, sleepiness, and anxiety remained virtually unchanged across test occasions and sessions, indicating that the decrease in pain was not mediated by emotional factors. Further placebo-controlled trials of auricular TENS in patients with phantom limb pain are recommended in order to evaluate the importance of electrical stimulation parameters such as pulse width and rate, and to establish the duration of pain relief.