B. ROBERT MEYER, M.D.
To the editor: The treatment of pain is one of the most troublesome and least understood aspects of the care of terminally ill patients. I was therefore pleased to see the American College of Physicians adopt a position on this issue (1). However, I have several comments on their recommendations.
There is an increasing body of evidence that meperidine should not be given to patients for the treatment of chronic pain, particularly patients with cancer. Excitatory phenomena in the central nervous system including hyperreflexia, tremors, multifocal myoclonus, and grand mal seizures have been shown to occur in these patients and
MEYER BR. Drugs for Severe Chronic Pain. Ann Intern Med. ;100:921–922. doi: 10.7326/0003-4819-100-6-921_3
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Published: Ann Intern Med. 1984;100(6):921-922.
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