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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0006525
Code Inist : 002B02B05. Création : 01/03/1996.