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ANALGESIA FOR CHRONIC PAIN WITHOUT RESPIRATORY DEPRESSION

STUART C. CULLEN, M.D.; CRISOSTOMO C. SANTOS, M.D.
AMA Arch Surg. 1954;69(3):410-414. doi:10.1001/archsurg.1954.01270030138013.
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REPORTED in this study, in which the drugs used were levorphan tartrate (levo-3-hydroxy-N-methylmorphinan tartrate dihydrate) and levallorphan tartrate (3-hydroxy-N-allylmorphinan tartrate), are the methods used in and the results of a survey to determine the dosage ratio of levorphan to levallorphan necessary to secure satisfactory analgesia with minimal respiratory embarrassment (Fig. 1). The inquiry was limited to patients with reasonably constant chronic pain who required narcotics. A total of 18 patients meeting these qualifications were studied (Table 1).

PROCEDURE OF INVESTIGATION  All observations were made by a single observer (C. C. S.). The 18 patients included both men and women, with ages ranging from 34 to 73 years. The severity of pain was graded as follows: 1, for mild pain; 2, for moderate pain; 3, for very uncomfortable pain, and 4, for very severe pain. In a preliminary interview with each patient preceding the application of the drugs, the reason for

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