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The Brompton mixture versus morphine solution given orally: effects on pain.

R Melzack, B M Mount, J M Gordon

    Canadian Medical Association Journal
    |February 17, 1979
    PubMed
    Summary
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    The Brompton mixture, a common pain relief for cancer patients, showed no significant difference compared to oral morphine alone. Both treatments effectively managed pain in approximately 85% of patients.

    Area of Science:

    • Palliative Care
    • Oncology
    • Pharmacology

    Background:

    • The Brompton mixture is a widely utilized formulation for managing cancer pain.
    • Its efficacy and side effect profile require rigorous scientific evaluation.

    Purpose of the Study:

    • To compare the efficacy and patient-reported outcomes of a standard Brompton mixture versus oral morphine alone.
    • To assess pain intensity, confusion, nausea, and drowsiness in cancer patients receiving these treatments.

    Main Methods:

    • A double-blind, crossover trial design was employed.
    • Oral administration of a standard Brompton mixture (morphine, cocaine, alcohol, syrup, chloroform water) and oral morphine alone.
    • Pain intensity measured using the McGill Pain Questionnaire; side effects assessed via patient and caregiver ratings.

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    Main Results:

    • No statistically significant differences were observed between the Brompton mixture and oral morphine for pain intensity or side effects.
    • Both treatment groups demonstrated effective pain relief in approximately 85% of participating cancer patients.
    • Patient and nurse/relative ratings for confusion, nausea, and drowsiness did not differ significantly between the two interventions.

    Conclusions:

    • The standard Brompton mixture offers no significant advantage over oral morphine alone in terms of pain relief or side effect profile in this patient population.
    • Oral morphine alone is an effective alternative for cancer pain management, comparable to the Brompton mixture.
    • Further research may explore optimal formulations and delivery methods for cancer pain control.