Levorphanol for Treatment of Intractable Neuropathic Pain in Cancer Patients

Reddy, Akhila; Ng, Amy; Mallipeddi, Tarun; Bruera, Éduardo

doi:10.1089/jpm.2017.0475

Cited by 6 publications

(3 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reddy et al felt that due to its multimodal mechanism of action, levorphanol is a drug which has been useful in treating chronic pain conditions such as phantom limb pain which is otherwise difficult to treat pharmacologically with regular medications. [4] Thus, levorphanol can be used in several chronic pain conditions such as cancer pain, chronic neuropathic pain, postherpetic neuralgia, spinal cord injury, central poststroke pain, fibromyalgia, and multiple sclerosis. It can be used orally, intramuscularly, and subcutaneously.…”

mentioning

confidence: 99%

Levorphanol: Rewinding an old, bygone multimodal opioid analgesic!

Nair

Upputuri

Mantha

et al. 2019

Indian J Palliat Care

View full text Add to dashboard Cite

mentioning

confidence: 99%

Levorphanol: Rewinding an old, bygone multimodal opioid analgesic!

Nair

Upputuri

Mantha

et al. 2019

Indian J Palliat Care

View full text Add to dashboard Cite

“…Consent may be easy to obtain in reporting of straightforward cases such as those published by our group regarding unique cancer pain syndromes and certain drug-related adverse effects. 7 However, one cannot obtain consent from a patient with advanced cancer or an authorized person when a family member blocked the delivery of appropriate care; when psychosocial distress contributed to increased pain expression, overuse of opioids, and unnecessary interventions; or when delirium resulted in misinterpretation of goals of care. 8,9 Moreover, in patients with advanced cancer receiving palliative care, the consent obtained at the time the case is reported may have to be obtained from a family member after the death of the patient.…”

mentioning

confidence: 99%

“…Knowledge of patients’ unique circumstances, family support, and coping strategies is vital to delivering the best possible personalized care. Consent may be easy to obtain in reporting of straightforward cases such as those published by our group regarding unique cancer pain syndromes and certain drug-related adverse effects . However, one cannot obtain consent from a patient with advanced cancer or an authorized person when a family member blocked the delivery of appropriate care; when psychosocial distress contributed to increased pain expression, overuse of opioids, and unnecessary interventions; or when delirium resulted in misinterpretation of goals of care .…”

mentioning

confidence: 99%

Patient and Caregiver Consent for Publication of Unidentifiable Case Reports—A Barrier to Medical Education and Patient Care

2019

Self Cite

View full text Add to dashboard Cite

A case report essentially describes the patient's story, including diagnosis, signs, symptoms, response to treatment, adverse reactions, and/or other unique findings. Case reports are considered to be informally collected anecdotal evidence that rely on personal testimony. Although randomized clinical trials and systematic reviews are emphasized in the hierarchy of clinical evidence, 1 case reports may help the clinician to generate a hypothesis and may be valuable for learning about adverse reactions of drugs, novel management strategies, and a variety of other clinical information. Case reports and case series lay down the foundation for future studies and help advance medical education. 2 Multiple research studies conducted by our research team were inspired by case reports published by other clinicians. Often, these reports are the first or only available evidence that clinicians have to learn about a spectrum of illness or its management. For example, recognition of the association between administration of thalidomide to mothers and malformations in their babies was triggered by reports of individual cases. 3 Case reports have been a method of reporting new findings in medical literature for decades, and they capture well the nuances and narrative aspect involved in the science and art of medical care. Moreover, teaching in medicine is often patient based, relying mostly on case discussions. 4 The publication of case reports did not previously require patient consent provided that patients were unidentifiable. However, recent changes in these requirements are cause for concern. Many journals (eg, Palliative Medicine, The BMJ journals, the Journal of Hematology & Oncology) 5 and institutes (eg, University of Texas MD Anderson Cancer Center) now require patient informed consent before they will accept case reports for publication, regardless of whether that patient is identifiable. Some journals may also be guided by national regulations that require patient consent. Other journals that clearly state that patient consent is required only for those case reports where the patient is identifiable, may subsequently request for patient consent despite the patient being unidentifiable. As medical professionals, we take thorough precautions to conceal any and all patient identifiers, such as demographics, ethnicity, profession, and other personal characteristics, prior to submission of case reports. Though we are invested in protecting our patients' privacy and anonymity, there is a concern that these requirements by some institutes and journals may interfere with clinicians' reporting of cases with unfavorable or unexpected outcomes, psychosocial issues, addiction, difficult family dynamics, or psychiatric diagnoses, all of

show abstract