Non-invasive pain control in the terminally ill patient

Although terminal patients with chronic pain are best managed with oral analgesia, patients who cannot take oral medication of ten receive treatment liy parenteral routes. Seventy consecutive terminal patients admitted to our hospice inpatient facility were evaluatedfor pain control over a three day period. Level ofpain was evaluated on a scale of zero to three (0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain). Patients were also evaluated for level of consciousness on a scale of one to four (1=alert, 2=confused, 3=semi-comatose, 4=comatose). Patients were medicated with morphine sulfate, either orally or by suppository, on a regular, four-hour schedule. Level of pain and level ofconsciousness evaluations were performed at the time each dose of morphine sulfate was administered. Data were compared for the level of pain and level of consciousness for the three day study period using Chisquared analysis. The results showed a significant decrease in levelofpain over the study period (p