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Biomedical subjects

R Melzack

Publications and source records attributed to R Melzack.

At least 109 records · Page 6Linked to original sources
PubMed1978

The management of intractable pain in patients with advanced malignant disease.

The Brompton mixture is a highly effective, flexible, safe and convenient means to control chronic pain of malignant disease. The mixture is a solution containing morphine, the dose of narcotic varying with the need for analgesia, and is given regularly, usually every 4 hours, with a phenothiazine. The main aims of therapy are prevention of pain rather than treatment, an unclouded sensorium and a normal effect. Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in 3 hospital environments: 1) a palliative care unit, 2) general wards and 3) private rooms. Pain was measured in 92 patients with the McGill-Melzack pain questionnaire. The Brompton mixture controlled pain in 90 per cent of patients in the palliative care unit and in 75 to 80 per cent of patients in the wards or private rooms. The differences in pain scores between patients in the palliative care unit and the other groups were significant. The mixture produced substantial decreases in the 3 major dimensions of pain: 1) sensory, 2) affective and 3) evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.

Analgesics, Opioid↗
PubMed1978

[Modes of action of various aspects of analgesia by stimulation].

A study of 12 patients suffering from chronic lumbar pain led to a comparison of the results of treatment with traditional acupuncture and that with transcutaneous electrical stimulation. The degree and quality of pain, as well as the duration of relief after treatment, were analyzed in an attempt to differentiate between the two forms of analgesia. Statistical analysis of the two methods showed no significant difference. Not only did they appear to have the same therapeutic merit, but it would also seem reasonable to suppose that they have a common mechanism at their origin. Intense stimulation of trigger points followed by relief of pain led us to compare them to acupuncture zones both in terms of topography and characteristics. There was a certain analogy of distribution, associated with a similarity of expression which led us to consider that these two techniques were possibly related to the same neurological process.

Acupuncture Therapy↗
PubMed1977

The management of intractable pain in patients with advanced malignant disease.

The Brompton mixture is a highly effective, flexible, safe and convenient means to control chronic pain of malignant disease. The mixture is a solution containing morphine, the dose of narcotic varying with the need for analgesia, and is given regularly, usually every 4 hours, with a phenothiazine. The main aims of therapy are prevention of pain rather than treatment, an unclouded sensorium and a normal effect. Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in 3 hospital environments: 1) a palliative care unit, 2) general wards and 3) private rooms. Pain was measured in 92 patients with the McGill-Melzack pain questionnaire. The Brompton mixture controlled pain in 90 per cent of patients in the palliative care unit and in 75 to 80 per cent of patients in the wards or private rooms. The differences in pain scores between patients in the palliative care unit and the other groups were significant. The mixture produced substantial decreases in the 3 major dimensions of pain: 1) sensory, 2) affective and 3) evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.

Aged↗
PubMed1976

The Brompton mixture: effects on pain in cancer patients.

Terminally ill cancer patients were given the Brompton mixture and a phenothiazine in an attempt to control their pain. The mixture was administered to patients in three hospital environments: a palliative care unit (PCU), general wards and private rooms. Pain was measured in 92 patients with the McGill-Melzack Pain Questionnaire. The Brompton mixture controlled pain in 90% of patients in the PCU and in 75% to 80% of patients in the wards or private rooms. The differences in pain scores between the PCU patients and the other groups were significant. The mixture produced substantial decreases in the three major dimensions of pain: sensory, affective and evaluative. Comparison of these results with data obtained in an outpatient pain clinic showed that the Brompton mixture was strikingly more effective than the traditional methods of managing cancer pain.

Affect↗
PubMed1976

Transcutaneous electrical stimulation and acupuncture: comparison of treatment for low-back pain.

Twelve patients suffering chronic low-back pain were treated with both acupuncture and transcutaneous electrical stimulation. The order of treatments was balanced, and changes in the intensity and quality of pain were measured with the McGill Pain Questionnaire. The results, based on a measure of overall pain intensity, show that pain relief greater than 33% was produced in 75% of the patients by acupuncture and in 66% by electrical stimulation. The mean duration of pain relief was 40 h after acupuncture and 23 h after electrical stimulation. Although the mean scores are larger for acupuncture than for transcutaneous stimulation, statistical analyses of the data failed to reveal significant differences between the two treatments on any of the measures. Both methods, therefore, appear to be equally effective, and probably have the same underlying mechanism of action. Consideration of the advantages and disadvantages of the two methods suggests that that transcutaneous electrical stimulation is potentially the more practical, since it can be administered under supervision by paramedical personnel.

Acupuncture Therapy↗
PubMed1976

[Acupuncture and pain mechanisms (author's transl)].

Three modulating mechanisms of the "gate-control theory" provide a plausible explanation of how acupuncture analgesia works. In particular, the inhibitory effects of the brainstem reticular formation on the transmission of pain signals in the spinal cord or at higher ttransmission levels seems to provide a powerful explanatory concept. Intense stimulation through acupuncture needles could activate this inhibitory brainstem system, thereby closing the gate to pain signals.

Acupuncture Therapy↗