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  1. Validation of world health organization guidelines for cancer pain relief : a 10-year prospective study.

    Article - En anglais

    This paper reports on the experience gained using World Health Organization Guidelines for cancer pain relief over a 10-year period in an anaesthesiology-based pain service associated with a palliative care programme.

    The course of treatment of 2118 patients was assessed prospectively over a period of 140,478 treatment days.

    Non-opioid analgesics (WHO step I) were used on 11%, weak opioids (WHO step II) on 31% and strong opioids (WHO step III) on 49% of treatment days.

    Administration was via the enteral route on 82% and parenterally on 9% of treatment days.

    On the remaining days, either spinally applied opioids (2%) or other treatments (6%) were utilised.

    Fifty-six percent of the patients were treated with morphine.

    Morphine dose escalation was observed in about one-half of the patients being cared for until death, whereas the other half had stable or decreasing doses over the course of treatment.

    In the final days of life, 84% rated their pain as moderate or less, while 10% were unable to give a rating.

    Analgesics remained constantly effective in all 3 steps of the WHO ladder.

    Other clinical symptoms were likewise significantly reduced at 1 week after initial assessment, with the exception of neuropsychiatric symptoms.

    Wide dissemination of WHO guidelines among doctors and healthcare workers is thus necessary to effect a clear improvement in the treatment of the many patients suffering from cancer pain in the clinical and home setting.

    Mots-clés Pascal : Analgésique, Adjuvant, Douleur, Traitement, Chimiothérapie, Tumeur maligne, OMS, Homme

    Mots-clés Pascal anglais : Analgesic, Adjuvant, Pain, Treatment, Chemotherapy, Malignant tumor, WHO, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0006525

    Code Inist : 002B02B05. Création : 01/03/1996.