A 4-DRUG PAIN REGIMEN FOR HEAD AND NECK CANCERS

Twenty patients with end-stage head and neck cancer, unresponsive to e ither acetaminophen with codeine or oxycodone hydrochloride, were plac ed on a four-drug analgesic regimen consisting of methadone hydrochlor ide, Trilisate(R) or acetaminophen, a tricyclic antidepressant, and, i n most cases, hydroxyzine. All drugs could be delivered through a feed ing tube, making this regimen appropriate for dysphagic patients. The efficacy of this nonparenteral regimen was assessed by structured pret reatment and posttreatment interviews that addressed pain intensity, a ctivity, and sleep levels. All of the patients showed improvement in t heir pain levels and 16 of the 20 had a greater than or equal to 50% i mprovement in all of their pain ratings (P < .01) that persisted until death (2 to 10 months later). Excellent results and ease of administr ation make this regimen a good choice for analgesia in terminal patien ts.