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American Society for Action on Pain

UI - 000213

AU - Mount BM

AU - Melzack R

AU - MacKinnon KJ

TI - The management of intractable pain in patients with advanced malignant disease

AB - AB - 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 UI - 79091506

SO - J Urol 1978;120:720-725