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Intrathecal morphine in the treatment of chronic intractable pain

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Summary

Fifteen patients with intractable pain received intrathecal morphine delivered via a programmable (Medtronic) device. In twelve patients the pain was due to cancer and three patients had pain of non malignant origin. All of the patients reported excellent or good relief. A total of 14 complications were reported in 7 patients. Most of these were minor and related to surgical or mechanical problems. One patient with pain of non malignant origin developed serious complications which required the removal of the infusion device. The results of this study show that chronic intrathecal infusion of morphine is superior to conventional forms of analgesia in patients with intractable pain of malignant origin. We would advise that it should remain a therapy of last resort in patients with intractable non malignant pain as the long term side effects are still unknown and the potential for serious side effects still exists.

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References

  1. Schultheiss, R., Schramm, J., Neidhardt, J. Dose changes in long- and medium-term intrathecal morphine therapy in cancer pain. Neurosurgery 1992: 31: 664–670.

    Article  PubMed  CAS  Google Scholar 

  2. Yaksh, T. L., Rudy, T. A. Spinal opiate analgesia: Characteristics and principles of action. Pain 1981: 11: 293–346.

    Article  PubMed  CAS  Google Scholar 

  3. Payne, R. Role of epidural and intrathecal narcotics and peptides in the management of cancer pain. Med. Clin. North Am. 1987: 71: 313–327.

    PubMed  CAS  Google Scholar 

  4. Penn, R. D., Paice, J. A. Chronic intrathecal morphine for intractable pain. J. Neurosurg. 1987: 67: 182–186.

    PubMed  CAS  Google Scholar 

  5. Shetter, A. G., Hadley, M. N., Wilkinson, E. Administration of intraspinal morphine sulfate for the treatment of intractable cancer pain. Neurosurgery 1986: 18: 740–747.

    Article  PubMed  CAS  Google Scholar 

  6. Coombs, D. W., Sauders, R. L., Gaylor, M. S. Relief of continuous chronic pain by intraspinal narcotics infusion via an implanted reservoir. JAMA 1983: 250: 17: 2336–2339.

    Article  PubMed  CAS  Google Scholar 

  7. Krames, E. S., Gershow, J., Glassberg, A. Continuous infusion of spinally administered narcotics for the relief of pain due to malignant disorders. Cancer 1985: 56: 696–702.

    Article  PubMed  CAS  Google Scholar 

  8. Onofrio, B.M., Yaksh, T. L. Long term pain relief produced by intrathecal morphine infusion in 53 patients. J. Neurosurgery 1990: 72: 200–209.

    CAS  Google Scholar 

  9. Goodman, R. R. Treatment of lower extremity reflex sympathetic dystrophy with continuous intrathecal morphine infusion. Appl. Neurophysiol. 1987: 50: 425–426.

    Article  PubMed  CAS  Google Scholar 

  10. Krames, E. S. Intrathecal infusion therapies for intractable pain: patient management guidelines. J. Pain Symptom Manage. 1993: 8(1): 36–46.

    Article  PubMed  CAS  Google Scholar 

  11. Foley, K. M. Treatment of cancer pain. N. Engl. J. Med. 1985: 313: 84–95.

    PubMed  CAS  Google Scholar 

  12. Yaksh, T. L., Rudy, T. A. Analgesia mediated by direct spinal action of narcotics: Science 1976: 192: 1357–1358.

    Article  PubMed  CAS  Google Scholar 

  13. Hassenbusch, S. J., Pillay, P. K., Magdinec, M., Currie, K., Bay, J. W. Convington, E. C., Tomaszewski, M. Z. Constant infusion of morphine for intractable cancer pain using an implanted pump. J. Neurosurgery 1990: 73: 405–409.

    CAS  Google Scholar 

  14. Onofrio, B.M., Yaksh, T.L., Arnold, P.G. Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. Mayo Clin. Proc. 1981: 56: 516–520.

    PubMed  CAS  Google Scholar 

  15. Sjoberg, M., Appelgren, L., Hultman, E. Long-term intrathecal bupivacaine: an efficient supplement in incomplete cancer pain control with intrathecal morphine. J. Pain Symptom Manage. 1988: 3: S12.

    Article  Google Scholar 

  16. Nitescu, P., Lennart, A., Linder, L. et al. Epidural versus intrathecal morphine bupivacaine: assessment of consecutive treatments in advanced cancer pain. J. Pain Symptom Manage. 1990: 5: 18–26.

    Article  PubMed  CAS  Google Scholar 

  17. Kitahata, L. M. Spinal analgesia with morphine and clonidine. Anesth. Analg. 1989: 68: 191–193.

    Article  PubMed  CAS  Google Scholar 

  18. Coombs, D. W., Saunders, R. L., Fratkin, J. D. Continuous intrathecal hydromorphone and clonidine for intractable pain. J. Neurosurg. 1986: 64: 890–894.

    Article  PubMed  CAS  Google Scholar 

  19. Lamb, S. A., Hosobuchi, Y. Intrathecal morphine sulfate for chronic benign pain delivered by implanted pump delivery systems. Adelaide, Australia: IASP Meeting, 1990: S120.

    Google Scholar 

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Chambers, F.A., MacSullivan, R. Intrathecal morphine in the treatment of chronic intractable pain. I.J.M.S. 163, 318–321 (1994). https://doi.org/10.1007/BF02943074

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