Journal of palliative medicine
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Dying in the preferred place is considered a key requirement for a "good death." The aims of our study were to explore preferred places of death of deceased people and their bereaved relatives in Rhineland-Palatinate (Germany). We further wanted to assess the congruence between preferred and actual place of death. ⋯ Because the availability of a relative was the most important factor to die in the preferred place, relatives of dying people should be supported in providing informal care. The introduction of palliative home care teams should allow more people to die in their preferred place by easing the burden of informal carers.
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Pain management disparities exist among patients not receiving palliative care. We examined pain outcomes for disparities among patients receiving palliative care. ⋯ Pain outcomes were similar or better among non-white races than whites. Surgical patients reported more final pain than cancer patients.
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Case Reports
The use of ketamine in severe cases of refractory pain syndromes in the palliative care setting: a case series.
The benefits of ketamine in reducing pain are largely based on case reports and small clinical trials. We present a case series describing the application and efficacy of subanesthetic doses of ketamine in the treatment of complex pain syndromes poorly responsive to escalating doses of opioids. ⋯ Optimal dosing titration, duration of initial treatment, and the role of maintenance ketamine need to be further elucidated. Our case series adds to the extant literature supporting the role of subanesthetic ketamine for refractory pain problems.