Morphine and the "lytic cocktail" for terminally ill patients in a French general hospital: evidence for an inverse relationship

Journal of Pain and Symptom Management
J Meunier-CartalF Boureau

Abstract

Undertreatment of cancer pain with analgesic drugs is still a frequent problem in French hospitals. In the absence of good analgesic practices, the use of a so-called lytic cocktail, which combines a neuroleptic (chlorpromazine), an opioid (meperidine), and an antihistamine (promethazine) has become common during the terminal phase of the disease. The lytic cocktail (LC) has been subsequently denounced as a type of disguised euthanasia. The aim of our study was to examine the prescription of morphine and lytic cocktail for terminally ill patients in a 427-bed French general hospital during a 3-year period (1989-1991) that coincided with the beginning of a pain relief service. The study was performed in two steps: a chart review of the 841 deceased patients during the observation period and an examination of morphine and parenteral promethazine consumption from the hospital pharmacy. Data from both the charts and the pharmacy showed an inverse relationship between these treatments. Morphine consumption increased while LC consumption decreased. The number of deceased patients who received LC were 24.4% in 1989, 19.9% in 1990, and 6.6% in 1991 (P < 0.001 between 1990 and 1991). The number of deceased who received morphine were 13....Continue Reading

References

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Citations

Apr 2, 2013·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Chrystèle LocherMichel Grivaux
Feb 15, 2001·Cancer Control : Journal of the Moffitt Cancer Center·J M Núñez Olarte, D G Guillen

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