Italy: status of cancer pain and palliative care.
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Humans↗
Biomedical subjects
Vittorio Ventafridda
Publications and source records attributed to Vittorio Ventafridda.
Paraplegia following coeliac plexus block.
Coeliac plexus block (CPB) is one of the few neurolytic procedures that is still considered very useful in managing chronic cancer pain. We describe what we believe to be the fifth case in the literature of paraplegia following coeliac plexus block with ethyl alcohol. Clinical and neurophysiological examination confirmed the hypothesis of an acute myelopathy probably caused by ischemia due to involvement of Adamkievicz's artery. The seriousness of this neurological complication led us to review the different pain-relieving strategies in pancreatic cancer. Several medical and surgical procedures are available for advanced pancreatic cancer, yet none of them alone can be considered the therapy of choice for all cases. Hence, only a multidisciplinary approach to pancreatic cancer pain can help in making the most appropriate choice for each patient.
Adenocarcinoma↗
Diclofenac does not modify morphine bioavailability in cancer patients.
We determined morphine plasma concentrations in 6 cancer patients before and with administration of diclofenac for 5 days. The non-steroidal anti-inflammatory drug does not modify morphine bioavailability. This observation suggests that diclofenac can be used in association with morphine during cancer pain treatment, without increasing the risk of overdosage or side effects of the opiate.
Aged↗
Cancer pain classification: a controversial issue.
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Humans↗
Hyperalgesia and myoclonus with intrathecal infusion of high-dose morphine.
We report the case of a patient who developed myoclonus and hyperalgesia following administration of high-dose subarachnoid morphine. This complication occurred with 40-80 mg/day continuous infusion. The pathophysiology of these side effects is discussed.
Drug Administration Schedule↗
Studies on the effects of antidepressant drugs on the antinociceptive action of morphine and on plasma morphine in rat and man.
In the rat we studied the effect of 3 tricyclic antidepressants: chlorimipramine, amitriptyline and nortriptyline, and the atypical antidepressant trazodone on pain thresholds when administered alone or together with morphine. Moreover, we evaluated the effect of the antidepressants on free morphine plasma concentrations both in the rat and in man. We observed that chlorimipramine and amitriptyline, two tricyclic antidepressants active on the serotoninergic system, induce analgesia and potentiate morphine analgesia in a dose-related fashion. The noradrenergic tricyclic nortriptyline and trazodone did not elicit analgesia and inconsistently affected morphine analgesia. In the rat, all drugs tested increased plasma concentrations of morphine with the exception of amitriptyline. In man, only chlorimipramine and amitriptyline increased the plasma concentration of the free opiate.
Amitriptyline↗
Semantic descriptors of pain.
Eighty-five patients suffering from advanced cancer pain were asked to attribute a 'definite value' to 5 key words describing pain by rating them on a visual analogue scale (VAS). The score which the patient attributed to each key word was then correlated with 9 variables obtained through patient monitoring files (sex, age, educational background, financial situation, integrated pain score, number of concomitant symptoms, hours of sleep and standing, performance status). The visual analogue rating of pain description was not related to the variables examined. However, important correlations were found: the higher the degree of pain, the higher the concomitant symptoms, and the greater reduction in hours of sleep and standing.
Female↗