Intraventricular Morphine Application by Means of Implanted Pump Systems in Paraneoplastic Pain Syndrome

  • G. Dieckmann
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 16)


After the discovery of specific opiate receptors in the brain and spinal cord (8), it was logical to think in therapeutic terms of applying opiates directly in the vicinity of these receptors. Thus spinal opiate administration proved to be highly effective in the treatment of pain (1, 9, 12). YAKSH (13) provided synoptic information on the pharmacological action of opiates. In the meantime, spinal analgesia has become widespread in the treatment of acute and chronic pain conditions, especially in pain due to carcinoma (3, 14). From a technical point of view, the use of implantable application systems with continuous or demand-controlled drug release was helpful, making long-term therapy feasible (3, 4). On the other hand, cerebral intraventricular opiate application is less widespread. It is restricted to chronic pain states in the cervicofacial region as well as to such states in disseminated carcinoma metastases and is linked with neurosurgical techniques. There have been communications on this since 1982 (5–7), and BLOND et al. (12) recently reported on experience in a large number of patients. Today, we communicate our own initial experiences with this invasive, but not ablative method in the neurosurgical treatment of chronic incurable pain states.


Epidural Morphine Morphine Concentration Spinal Analgesia Multiple Bone Metastasis Morphine Hydrochloride 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • G. Dieckmann
    • 1
  1. 1.Abteilung für Funktionelle NeurochirurgieZentrum für Neurologische MedizinGöttingenGermany

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