[Delirium is certainly not an unavoidable complication of pain control in the terminal phase of life].
In three terminal patients, a man aged 19 years who suffered from progressive osteosarcoma, a man aged 71 years with a small-cell pulmonary carcinoma, and a 68-year-old woman with cerebral metastases from a mammary carcinoma, delirium developed due to increased dosage of opioids for seemingly intractable pain (the first two patients) and dexamethasone (third patient). The delirium subsided after opioid rotation, administration of drugs for neuropathic pain, and treatment with an antipsychotic, respectively. This enhanced the patients' quality of terminal life and quality of dying. In terminal patients, analgesics-induced delirium must be considered, diagnosed and treated without delay.
van der Ligt
W
W
Universitair Medisch Centrum St Radboud, afd. Huisartsgeneeskunde, Nijmegen.
Koelewijn
M
M
Zylicz
Z
Z
D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D000700:Analgesics / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects; D003693:Delirium / Q000139:chemically induced* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care
D000700:Analgesics; D000701:Analgesics, Opioid