Indian journal of palliative care
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Indian J Palliat Care · Sep 2011
Reporting of pediatric palliative care: a systematic review and quantitative analysis of research publications in palliative care journals.
Pediatric palliative care clinical practice depends upon an evidence-based decision-making process which in turn is based upon current research evidence. ⋯ The overall reporting rate for pediatric palliative care articles in palliative care journals was very low and there were no randomized clinical trials and systematic reviews found. The study findings indicate a lack of adequate evidence base for pediatric palliative care.
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Indian J Palliat Care · Sep 2011
Opioid-prescribing Practices in Chronic Cancer Pain in a Tertiary Care Pain Clinic.
Under treatment of pain is a recognized global issue. Opioid analgesic medication is the mainstay of treatment in cancer patients as per the World Health Organization (WHO) pain relief ladder, yet 50% of cancer patients worldwide do not receive adequate pain relief or are undertreated. ⋯ This study shows that the under treatment of pain and under dosing of opioids coupled with improper side effect management are major issues.
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Indian J Palliat Care · Sep 2011
Case ReportsDexmedetomidine infusion to facilitate opioid detoxification and withdrawal in a patient with chronic opioid abuse.
Many patients are admitted to the intensive care unit (ICU) for acute intoxication, serious complication of overdose, or withdrawal symptoms of illicit drugs. An acute withdrawal of drugs with addiction potential is associated with a sympathetic overactivity leading to marked psychomimetic disturbances. ⋯ Herein, we report a case of a chronic opioid abuse (heroin) patient admitted with acute overdose complications leading to a prolonged ICU course requiring sedative-analgesic medication; the drug withdrawal-related symptoms further complicated the weaning process. Dexmedetomidine infusion was successfully used as a sedative-analgesic to control the withdrawal-related psychomimetic symptoms and to facilitate smooth detoxification and weaning from opioid and other sedatives.