<b>Do normal saline and distilled water </b><b>belong to the analgesics ? </b>

Abstract

We reported four patients who received the treatment for severe pain with normal saline and/or distilled water injections. They suffered from various kinds of severe pain. The diagnoses were, a chest pain from bone metastases of terminal liver cancer (Case 1), a low back and leg pain from lumbar spinal canal stenosis (Case 2), a scar pain after thoracic drainage (Case 3) and a postherpetic pain in cervical region (Case 4). All patients received the treatment consisted of nonsteroidal anti-inflammatory drugs (NSAIDs) and pentazocine and/or continuous epidural block, but pain relief was a little and incomplete. While they requested more potent pain relieving measures, but received injections of normal saline and/or distilled water. They recognized that "analgesic" injections had either some effect or no effect, but their physicians thought of the complaints as " psychogenic" one. After consulting to our clinic, we informed them in detail about the treatments with morphine and/or codeine. All 4 patients received our proposal, oral codeine (Case 2, 3) or continuous intravenous/oral morphine (Case 1, 4) started. Pain effectively relieved in all cases with satisfaction.In the treatment of pain, the word, "believe the patient's report of pain", is the most fundamental principle. When patients complain of pain, they really suffer from pain and want more potent or much doses of analgesic, not normal saline or distilled water! At that time, physician should " believe the patient's report of pain" and provide reliable pain-relieving therapies.