[Current status of pain relief with Chinese herbal drugs in patients with cancer].
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Abstract: Inadequate cancer pain relief has been documented extensively across historical records. In response, in 1986, the World Health Organization (WHO) developed guidelines for cancer pain treatment. The purpose of this paper is to disseminate the results of a comprehensive, integrative review of studies that evaluate the effectiveness of the WHO guidelines. Studies were included if they: 1) identified patients treated with the guidelines, 2) evaluated self-reported pain, 3) identified instruments used, 4) provided data documenting pain relief, and 5) were written in English. Studies were coded for duration of treatment, definition of pain relief, instruments used, findings related to pain intensity or relief, and whether measures were used other than the WHO analgesic ladder. Twenty-five studies published since 1987 met the inclusion criteria. Evidence indicates 20%–100% of patients with cancer pain can be provided pain relief with the use of the WHO guidelines – while considering their status of treatment or end-of-life care. Due to multiple limitations in included studies, analysis was limited to descriptions. Future research to examine the effectiveness of the WHO guidelines needs to consider recommendations to facilitate study comparisons by standardizing outcome measures. Recent studies have reported that patients with cancer experience pain at moderate or greater levels. The WHO guidelines reflect the knowledge and effectual methods to relieve most cancer pain, but the guidelines are not being adequately employed. Part of the explanation for the lack of adoption of the WHO guidelines is that they may be considered outdated by many because they are not specific to the pharmacological and interventional options used in contemporary pain management practices. The conundrum of updating the WHO guidelines is to encompass the latest pharmacological and interventional innovations while maintaining its original simplicity. Keywords: cancer, pain, World Health Organization, review, guidelines
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Objective:To evaluate the safety and efficacy of neurolytic celiac plexus bloek(NCBP)in controlling pain due to upper abdominal malignancies.Methods:11 patients with advanced malignancies accepted NCBP.All procedures were performed via pre-crus of diaphragm approach under CT guidance.Results:The technical success was 100% in 11 cases.1 week after the procedure,CR(complete relief),PR(partial relief),and MR(moderate relief)were achieved in 7,3 and 1 patients respec tively,producing the effective rate of 90.9%.2 months after the procedure.CR,PR,and MR were achieved in 5,3 and 3 pa tients respectively,producing the effective rate of 72.7%.Postural hypotension occurred in 3 patients,and diarrhea occurred in 3 patients.Conclusion:NCBP is a safe and effective treatment in controlling pain due to upper abdominal malignancies.
Celiac plexus
Diaphragm (acoustics)
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s and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Intensive Care Medicine
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Interest and participation in state cancer pain initiatives have grown rapidly in the past 5 yr. Of signal importance to these state efforts is the fact that several national groups have made relief of cancer pain a priority. State cancer pain initiatives will play a key role in disseminating basic pain-management information, in changing practice and ultimately in evaluating the effectiveness of cancer pain control efforts. They are dedicated to making relief of cancer pain a reality. That is a challenge that will occupy them for many years to come.
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Objective To study the methods and therapeutic effect of neurolytic celiac plexus block in treatment of intractable upper abdominal pain caused by cancer.Methods All the 30 patients with carcinoma of upper abdominal organs suffered from intractable upper abdominal pain.Ethanol was injected through neurolytic celiac plexus block under CT guidance with needle tip positioned into the tumorous retroperitoneal lymph nodes.Results The success rate was 100%.CT results showed ethanol diffused well in lymph nodes and surrounding aorta.The total effective rate of pain relief was 100% in two weeks and 71.4% in 6 months.Conclusion Neurolytic celiac plexus block using CT guidance is worth widely applying to clinics for its accurately choosing position,a high rate of pain relief and few complications.
Celiac plexus
Intractable pain
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Cancer pain sends a message. It is frightening to the patient. It heralds progression or recurrence to the oncologist. It is a biological readout of the cancer-nerve interaction for the scientist. Nerves have been considered bystanders within the cancer microenvironment. However, emerging information suggests that nerves are recruited and participate in the carcinogenic process. These newly formed fibers respond to mediators secreted by constituents of the cancer microenvironment. In this manner, these nerves serve as bellwethers and sensors embedded within the cancer. When we rigorously assess patients' cancer pain, we gain insight into the action of cancer. An enhanced understanding of cancer pain offers biological questions that if answered might not only provide relief from cancer pain but might also improve survival.
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Most cancer patients experience different levels of pain.Cancer-related pain would influence quality of life,decrease survival will of cancer patients,and may also induce tumors to progress and metastasize.Cancer Pain control now remains a tough staff,although various methods have been used clinically.The main progression on cancer-related pain control with traditional chinese medicine and western medicine will be reviewed in this paper.
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Western medicine
Pain medicine
Pain control
Life quality
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