Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Apr 2009
Randomized Controlled Trial Multicenter StudyUse of a lidocaine patch in the management of postsurgical neuropathic pain in patients with cancer: a phase III double-blind crossover study (N01CB).
Current therapies often have limited efficacy and untenable side effects when used to treat persistent incisional pain following cancer-related surgery. Lidocaine patches reduce neuropathic pain from herpes zoster but their benefits for persistent cancer-related postsurgical incisional pain remain unclear. ⋯ Lidocaine patch use did not significantly reduce pain intensity ratings or the majority of related secondary end points in cancer patients with persistent incisional pain.
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Support Care Cancer · Apr 2009
Comparative Study Controlled Clinical TrialUse of oxygen and opioids in the palliation of dyspnoea in hypoxic and non-hypoxic palliative care patients: a prospective study.
Dyspnoea is a complex experience of the body and the mind. Whereas the effects of opioids on dyspnoea in advanced disease have been the focus of studies for management of dyspnoea in palliative medicine, the role of oxygen is still unclear. The effects of symptomatic oxygen and opioid treatment on ventilation and palliation of dyspnoea in hypoxic (H) and non-hypoxic (NH) palliative care patients were assessed and compared. ⋯ In this study, opioids worked significantly better than oxygen in reducing the intensity of dyspnoea even in hypoxic patients. There was no correlation between intensity of dyspnoea and oxygen saturation in H and NH patients. Oxygen should be seen as a pharmacological agent and not be given based on intuitive assumption of benefit.
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Decision making in the context of palliative care is particularly complex given the unpredictable illness trajectories experienced by patients and the number of individuals who may be part of decision-making processes. This study aimed to describe the significant issues that influence the processes of care decision making, from the perspective of patients with advanced illness. ⋯ The main issue experienced by palliative care patients was identified as a lack of involvement in decision making. One of the significant factors affecting the decision process is the type of relationship with health professionals that patients believe enhances their involvement in decision making. This was determined by the manner and focus of the health professional, their trustworthiness as well as the healthcare culture and environment. This paper provides a greater understanding of the perspective of patients in relation to their involvement in decisions related to palliative care.