ABSTRACT
Dentro del marco conceptual del cuidado terminal, se utilizó clorhidrato de morfina en solución por vía oral, en forma racional y pautada, desde mayo de 1986. Se hizo un estudio retrospectivo de los 40 pacientes a los que se trató de esta forma hasta julio de 1987; ellos representaron el 24% del total de pacientes terminales asistidos en el mismo lapso. La edad promedio fue de 70 años. Alrededor de 1/3 fueron ambulatorios. La dosis inicial diaria media de morfina fue de 60 mg y la dosis promedio diaria media, de 120 mg y el tiempo medio de tratamiento, 45 días. Cuando se consideró necesario, de acuerdo al síntoma, se asoció medicación coadyuvante. El síntoma más frecuente fue dolor por masa tumoral (67,5%), y en menor proporción (alrededor de un 20% cada uno) "dolor por compresión - invasión nerviosa", "dolor óseo", y en secundarios, especialmente náuseas, vómitos, estreñimiento, y somnolencia o torpor por más de 4 días. Los resultados se valoraron como "buenos" en un 85% de los casos, y "regulares" en el 15% restante. La única diferencia estadísticamente significativa entre ambos grupos, fue una concentración mayor de síntomas diversos en los pacientes con resultados "regulares"
Subject(s)
Humans , Male , Female , Morphine/administration & dosage , Terminal Care , Administration, Oral , Retrospective StudiesABSTRACT
Dentro del marco conceptual del cuidado terminal, se utilizó clorhidrato de morfina en solución por vía oral, en forma racional y pautada, desde mayo de 1986. Se hizo un estudio retrospectivo de los 40 pacientes a los que se trató de esta forma hasta julio de 1987; ellos representaron el 24% del total de pacientes terminales asistidos en el mismo lapso. La edad promedio fue de 70 años. Alrededor de 1/3 fueron ambulatorios. La dosis inicial diaria media de morfina fue de 60 mg y la dosis promedio diaria media, de 120 mg y el tiempo medio de tratamiento, 45 días. Cuando se consideró necesario, de acuerdo al síntoma, se asoció medicación coadyuvante. El síntoma más frecuente fue dolor por masa tumoral (67,5%), y en menor proporción (alrededor de un 20% cada uno) "dolor por compresión - invasión nerviosa", "dolor óseo", y en secundarios, especialmente náuseas, vómitos, estreñimiento, y somnolencia o torpor por más de 4 días. Los resultados se valoraron como "buenos" en un 85% de los casos, y "regulares" en el 15% restante. La única diferencia estadísticamente significativa entre ambos grupos, fue una concentración mayor de síntomas diversos en los pacientes con resultados "regulares" (AU)
Subject(s)
Humans , Male , Female , Terminal Care , Morphine/administration & dosage , Administration, Oral , Retrospective StudiesABSTRACT
From May 1986 until July 1987, oral morphine hydrochloride in water solution was used in terminal patients, under a strict protocol of administration, and complying with the basic principles of Palliative Care. A retrospective study was carried out on the 40 patients who had received the drug for more than three consecutive days. As shown in Table 1, the average age of the treated patients was 70 years. The ambulatory patients represented 27.5% of the sample. The average initial dose was 60 mg, and the average maintenance dose was 120 mg. The median treatment time was 45 days. "Good" results were achieved in 85% of the patients, and "fairly good" in the remainder ("good" results were defined as "satisfactory symptom control, good life quality"--in this group there were some patients who obtained total suppression of the symptoms and optimal life-quality, i.e. "excellent" results; "bad" results were defined as "total absence of therapeutic effect"; and "fairly good" results, the intermediate cases). The more frequently treated symptoms were: 67.5%, pain due to tumor mass; and 20%, pain due to nerve compression-invasion, bone pain, and dyspnoea due to pulmonary metastases or primary lung cancer: total symptoms was more than a hundred per cent, because a number of patients had more than one symptom. Whenever necessary, adjuvant drugs were employed. Side effects were seen in 37% of the patients (specially nausea, vomiting, constipation, and somnolence for more than four days).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Morphine/administration & dosage , Terminal Care , Administration, Oral , Aged , Female , Humans , Male , Retrospective StudiesABSTRACT
From May 1986 until July 1987, oral morphine hydrochloride in water solution was used in terminal patients, under a strict protocol of administration, and complying with the basic principles of Palliative Care. A retrospective study was carried out on the 40 patients who had received the drug for more than three consecutive days. As shown in Table 1, the average age of the treated patients was 70 years. The ambulatory patients represented 27.5
of the sample. The average initial dose was 60 mg, and the average maintenance dose was 120 mg. The median treatment time was 45 days. [quot ]Good[quot ] results were achieved in 85
of the patients, and [quot ]fairly good[quot ] in the remainder ([quot ]good[quot ] results were defined as [quot ]satisfactory symptom control, good life quality[quot ]--in this group there were some patients who obtained total suppression of the symptoms and optimal life-quality, i.e. [quot ]excellent[quot ] results; [quot ]bad[quot ] results were defined as [quot ]total absence of therapeutic effect[quot ]; and [quot ]fairly good[quot ] results, the intermediate cases). The more frequently treated symptoms were: 67.5
, pain due to tumor mass; and 20
, pain due to nerve compression-invasion, bone pain, and dyspnoea due to pulmonary metastases or primary lung cancer: total symptoms was more than a hundred per cent, because a number of patients had more than one symptom. Whenever necessary, adjuvant drugs were employed. Side effects were seen in 37
of the patients (specially nausea, vomiting, constipation, and somnolence for more than four days).(ABSTRACT TRUNCATED AT 250 WORDS)
