Neurotoxic effects of opioids
Alf Kornelius Olsen and Per Sjøgren
pp 139-142
Opioid effects may be classified as either desirable or undesirable. Undesirable effects are classically termed as opioid toxicity or side effects. The desirability factors may change depending upon clinical-indications for the use of opioids.
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The role of ketamine in pain control
Marie T Fallon and John Welsh
pp 143-146
Ketamine has been used for 30 years as a dissociative general anaesthetic. Ketamine activates the limbic system and depresses the cerebral cortex, producing profound analgesia, slight respiratory depression, cardiovascular stimulation and amnesia. The protective reflexes are maintained.
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Transdermal opioid control of cancer pain
Irene Spencer
pp 147-149
Whether in the home, hospital or hospice, the overriding aim of nurses providing palliative cancer care is to give patients the best quality of life attainable. Despite the advances in cancer care in recent years, however, there is evidence that many cancer sufferers still experience unacceptably high levels of pain and problems associated with analgesia. Consequently, those patients cannot be said to achieve the best quality of life attainable.
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Complementary therapies in palliative care
Andrew Vickers
pp 150-153
Complementary therapies such as acupuncture, homeopathy, chiropractic and massage are widely practised by health professionals and widely used by the public. A study of the South West Thames area in the UK found that one in five GPs and one in eight hospital consultants practised a complementary therapy and a recent survey estimated that 10% of the British public visit a practitioner of complementary therapies each year.
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Specialist care – from organisational audit to practice
Pam Caddow
pp 154-157
The specialist palliative care service discussed in this article is provided by an interdisciplinary, hospital-based symptom control/support team (SC/ST), operating in Barnet General Hospital (BGH) and Edgware General Hospital (EGH) in the UK.
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Returning foreign patients to their home country
Isabelle Marin, Nicole Dizengremel and Sylvie Fornasier
pp 158-163
A team of carers will too often be confronted by a request for emergency repatriation: the patient is already close to death and the family is only suddenly aware of what is happening. Financial and medical considerations can make this an impossible or sordid business.
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Living wills: studying the Dutch experience
Jenny Doig
pp 164-166
Nurses caring for patients with HIV in the UK began to encounter living wills after the 1992 publication of the Terrence Higgins Trust’s Living Wills. The Royal College of Nursing produced a basic guidance sheet and a few articles on the subject appeared in the British nursing press, but very little was available on the practical and ethical issues raised by their use.
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Confronting the reality of terminal illness
Frances Kraus
pp 167-170
Patients attending the day centre at St Christopher’s Hospice in London, UK, confront the inevitability of their own death whenever another member dies. The value to patients of attending the day centre has never been seriously questioned, but the therapeutic aspects nominated as valuable by professionals are often those that are nurturing to patients and boost self-esteem – such as hairdressing and aromatherapy – or would provide distraction (concerts or outings to a garden or museum).
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The emotional cost of palliative care
John Costello
pp 171-174
The increasing prolongation of life that accompanies many life threatening cancer and non-cancer conditions can result in a protracted period of illness requiring palliative care. An imminent death can give rise to a wide range of emotional experiences for the dying person and their surviving family members.
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