Chronic intrathecal morphine for intractable pain.

Forty-three patients with intractable pain received intrathecal morphine delivered by implanted continuous-infusion (Infusaid) or programmable (Medtronic) devices. In 35 patients the pain was due to cancer, and eight patients had chronic nonmalignant pain. The origin of the nonmalignant pain included lumbar arachnoiditis, multiple sclerosis, severe osteoporosis resulting in a thoracic compression fracture, and intractable pain as a consequence of cancer therapy in individuals cured of their disease. Twenty-eight (80%) of the patients with cancer-related pain experienced excellent or good relief. Side effects were rare. Tolerance occurred infrequently and could be managed effectively. The results of this study support earlier studies on the application of chronic intrathecal morphine for intractable cancer pain. These findings also indicate that, in carefully selected patients, nonmalignant pain may be managed satisfactorily with this technique.

[1]  A. Shetter,et al.  Administration of intraspinal morphine sulfate for the treatment of intractable cancer pain. , 1986 .

[2]  A. Auld,et al.  Intraspinal Narcotic Analgesia in the Treatment of Chronic Pain , 1985, Spine.

[3]  E. Krames,et al.  Continuous infusion of spinally administered narcotics for the relief of pain due to malignant disorders , 1985, Cancer.

[4]  S. Savage,et al.  Intrathecal morphine tolerance: use of intrathecal clonidine, DADLE, and intraventricular morphine. , 1985, Anesthesiology.

[5]  R. Penn,et al.  Cancer pain relief using chronic morphine infusion. Early experience with a programmable implanted drug pump. , 1984, Journal of neurosurgery.

[6]  R. Harbaugh,et al.  Relief of continuous chronic pain by intraspinal narcotics infusion via an implanted reservoir. , 1983, JAMA.

[7]  J. Weston,et al.  Intrathecal and intraventricular morphine for pain in cancer patients: initial study. , 1983, Journal of neurosurgery.

[8]  W. Ensminger,et al.  Benefit from and tolerance to continuous intrathecal infusion of morphine for intractable cancer pain. , 1982, Journal of neurosurgery.

[9]  R. Ojemann,et al.  Cancer Pain Relieved by Long-Term Epidural Morphine with Permanent Indwelling Systems for Self-Administration , 1982 .

[10]  R. Saunders,et al.  Epidural narcotic infusion reservoir: implantation technique and efficacy. , 1982, Anesthesiology.

[11]  R. Harbaugh,et al.  Implanted continuous epidural morphine infusion system. Preliminary report. , 1982, Journal of neurosurgery.

[12]  T. Yaksh Spinal opiate analgesia: Characteristics and principles of action , 1981, PAIN®.

[13]  T. Yaksh,et al.  Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. , 1981, Mayo Clinic proceedings.

[14]  T. Yaksh,et al.  Studies in the primate on the analgetic effects associated with intrathecal actions of opiates, alpha-adrenergic agonists and baclofen. , 1981, Anesthesiology.

[15]  John E. Thomas,et al.  Pain relief by intrathecally applied morphine in man. , 1979, Anesthesiology.