Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions


Answer 3
  1. Refer patient for consideration of celiac plexus block. A celiac plexus block may control pain in up to 75% of patients with pancreatic cancer and allow reduction of opioid doses and their side effects. The patient’s pain is well controlled on his current regimen, so increasing analgesics is not necessary. Opioid rotation is sometimes helpful, but the suggested starting dose of transmucosal fentanyl is 200 g. The addition of nalbuphine is contraindicated in patients using full -receptor agonists. Finding a means to continue analgesia with fewer side effects is a goal of rational pain management.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj