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Biomedical subjects

R B Patt

Publications and source records attributed to R B Patt.

At least 37 records · Page 2Linked to original sources
PubMed1994

Pharmacotherapy for cancer pain: an anaesthesiologist's viewpoint.

Cancer pain is prevalent and undertreated despite the availability of therapeutic options that, taken together are highly effective, economical and safe. Improved understanding of the pharmacology of chronically-administered opioids has resulted in reduced concerns about addiction and an increased emphasis on their use. The anaesthetist may play a pivotal role in cancer pain management by the provision of nerve blocks and other interventions, but, to be a truly effective consultant, must also be expert in all aspects of pharmacotherapy. A rationale for the development of pharmacologic expertise together with a review of assessment and pharmacologic management of cancer pain are provided.

Analgesics↗
PubMed1994

Spinal neurolysis for cancer pain: indications and recent results.

Effective control of cancer pain can now be achieved in a high proportion of patients with rigorously applied pharmacologic treatment, reducing the need for more demanding invasive procedures. Ten to thirty percent of patients will, however, require some form of more aggressive management, ranging from the parenteral and spinal administration of opioids to neurodestructive procedures. Intrathecal neurolysis is a time-tested procedure that, although used less frequently than in the past, still has important indications. Guidelines for patient selection and results of a recent clinical series are presented here.

Clinical Protocols↗
PubMed1992

Transdermal fentanyl for chronic cancer pain: detailed case reports and the influence of confounding factors.

Patients were entered into an open label study to evaluate the efficacy of transdermal fentanyl as an analgesic for chronic cancer pain. The clinical course of 3 patients is described as well as an emphasis on the apparent influence of confounding factors, i.e., factors unique to each patient that appeared to affect that individual's analgesic requirements. Our anecdotal clinical experience suggests that transdermal fentanyl is an acceptable, efficacious, and safe means of pharmacologic management for patients with chronic cancer pain. Our results reinforce the concept that cancer pain is a dynamic, multiply determined process and that, as a result, the effects of a single intervention are difficult to analyze.

Administration, Cutaneous↗
PubMed1992

PCA: prescribing analgesia for home management of severe pain.

Home-based patient-controlled analgesia (PCA) provides select patients with the ability to deliver analgesia based on their own perception of need. PCA allows the patient with severe pain (eg, from cancer) to remain in the home when treatment by oral or rectal routes is no longer appropriate. Patient selection criteria include intact cognition and proper supervision from a family member or health professional. The physician remains responsible for determining the appropriate drug, bolus dose, background infusion rate, and lockout interval. Many of the guidelines that govern these parameters are similar to those that underlie traditional oral therapy.

Administration, Oral↗
PubMed1990

Superior hypogastric plexus block for pelvic cancer pain.

Blockade of the superior hypogastric nerve plexus was performed for relief of chronic cancer related pelvic pain. The targeted sympathetic nerves lie anterior to the sacral promontory. Twenty-eight patients with neoplastic involvement of pelvic viscera secondary to cervical, prostate, and testicular cancer or radiation injury were treated with neurolytic superior hypogastric plexus block. Sympathetically mediated pain was significantly reduced or eliminated in all cases and no serious complications occurred. Superior hypogastric plexus block is recommended for diagnostic/prognostic and therapeutic purposes in patients with chronic pelvic pain, particularly when pain is of neoplastic origin.

Abdominal Pain↗