Chronic intrathecal morphine for intractable pain.

@article{Penn1987ChronicIM,
  title={Chronic intrathecal morphine for intractable pain.},
  author={Richard D. Penn and Judith A. Paice},
  journal={Journal of neurosurgery},
  year={1987},
  volume={67 2},
  pages={
          182-6
        }
}
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… 
View on PubMed
thejns.org
206 Citations
Highly Influential Citations
7
Background Citations
33
Methods Citations
1
Results Citations
1

206 Citations

Citation Type

Citation Type

Intrathecal morphine in the treatment of chronic intractable pain
TLDR
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 and should remain a therapy of last resort.
Response of intractable pain to continuous intrathecal morphine: a retrospective study
Epidural and intrathecal analgesia for cancer pain.
TLDR
This chapter summarizes the clinical use of non-opioid agents used intraspinally either alone or in combination with opioids in the treatment of intractable cancer pain.
Intrathecal morphine and bupivacaine in advanced cancer pain patients implanted at home.
Constant infusion of morphine for intractable cancer pain using an implanted pump.
TLDR
The purpose of the study was to demonstrate that the epidural route is effective with minimal complications, and that screening with temporary epidural catheter infusions results in a high rate of subsequent pain relief.
Intrathecal morphine delivered via subcutaneous pump for intractable pain in pancreatic cancer.
Constant infusion of morphine for intractable cancer pain using an implanted pump.
TLDR
The purpose of the study was to demonstrate that the epidural route is effective with minimal complications, and that screening with temporary epidural catheter infusions results in a high rate of subsequent pain relief, and to suggest that significant reductions in cancer pain can be obtained with few complications and a low morphine tolerance rate.
Does intrathecal morphine in the treatment of cancer pain induce the development of tolerance?
TLDR
The results demonstrated that only a moderate increase in daily dose of intrathecal morphine was required during the course of treatment, and this increase did not result in any central opioid-related side effects, and the pain was managed satisfactorily.
A prospective study of long-term intrathecal morphine in the management of chronic nonmalignant pain.
TLDR
Continuous intrathecal morphine can be a safe, effective therapy for the management of severe, nonmalignant pain among a carefully selected patient population and can result in long-term improvement in several areas of daily function.
Intraspinal morphine for chronic pain: a retrospective, multicenter study.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 18 REFERENCES
Administration of intraspinal morphine sulfate for the treatment of intractable cancer pain.
TLDR
It is concluded that intraspinal morphine sulfate is a beneficial treatment option for cancer patients in whom pain has become debilitating and unresponsive to oral or parenteral narcotic regimes.
Continuous infusion of spinally administered narcotics for the relief of pain due to malignant disorders
TLDR
Continuous infusion of spinally administered narcotics using a totally implantable drug delivery system such as the INFUSAID model 400 is a safe, complication‐free procedure for the control of cancer‐related pain.
Intrathecal and intraventricular morphine for pain in cancer patients: initial study.
TLDR
Intractable pain in six cancer patients was treated with lumbar intrathecal morphine and intraventricular morphine and daily percutaneous injections of morphine through Ommaya reservoirs were made.
Relief of continuous chronic pain by intraspinal narcotics infusion via an implanted reservoir.
TLDR
The results of this study confirm the sustained analgesic efficacy reported earlier in cancer-related pain syndromes, thus supporting further cautious expansion of this therapy within the cancer- related pain population and discouraged from further use in the patient with chronic nonmalignant pain.
Benefit from and tolerance to continuous intrathecal infusion of morphine for intractable cancer pain.
TLDR
A patient with painful bilateral metastatic lumbosacral plexopathy from cervical cancer was treated with levorphanol tartrate (Levo-Dromoran), 4 mg orally every 4 hours, with poor pain relief, and the intrathecal morphine dose was increased from 17.5 to 96 mg/day because of inadequate pain relief.
Cancer pain relief using chronic morphine infusion. Early experience with a programmable implanted drug pump.
TLDR
Fourteen patients were implanted with drug pumps to provide chronic epidural or intrathecal morphine to relieve pain due to cancer and the programmable device has the obvious advantage of being able to vary dose according to patient need and requires less frequent refilling.
Intraspinal Narcotic Analgesia in the Treatment of Chronic Pain
TLDR
In those patients qualifying for continuous delivery systems (CDS), 65% had good to excellent relief of pain while 34% were considered failures for a variety of reasons.
Implanted continuous epidural morphine infusion system. Preliminary report.
TLDR
Functional characteristics of the system, technique of implantation, and preliminary results in two patients treated by this method are presented.
Pain relief by intrathecally applied morphine in man.
Pain Relief by Intrathecally Applied Morphine in Man Josef Wang;Lee Nauss;Juergen Thomas; Anesthesiology
Studies in the primate on the analgetic effects associated with intrathecal actions of opiates, alpha-adrenergic agonists and baclofen.
TLDR
Results clearly indicate that a powerful analgesia can be produced by selectively activating adrenergic, opiate, and baclofenergic receptor systems in the spinal cord.
...
1
2
...