author={M. Behar and David Olshwang and Florella Magora and J. T. Davidson},
  journal={The Lancet},
Epidural injections of a 2 mg morphine were given to 10 patients with severe acute or chronic pain. All cases had considerable amelioration of pain, which commenced within 2-3 min, reached a peak in 10-15 min, and was effective for 6-24 h. It is suggested that the morphine reached the subarachnoid space and produced its effect by direct action on the specific opiate receptors in the substantia gelatinosa of the posterior-horn cells of the spinal cord. 
Intermittent epidural morphine instillation for control of postoperative pain.
The first instance of paraplegia in association with epidural morphine anesthesia has been reported, and significant side effects are uncommon, but pronounced respiratory depression can occur late and careful observation is necessary. Expand
Obstetric pain relief using epidural morphine
Epidural injections of morphine (2·5 or 4 mg) were given to 25 patients in labour and it is felt that this technique merits further investigation in view of its potential advantages over more traditional methods of pain relief in labour. Expand
Failure of epidural morphine to relieve pain in labour
Assessment of pain using a visual analogue scoring system revealed no appreciable relief of pain 30 min after morphine injection, in contrast to the reported efficacy of epidural morphine 2 mg in the treatment of severe pain other than labour. Expand
Intrathecally Applied Morphine for Treatment of Postoperative and Chronic Pain
Eleven patients suffering from metastases to the lumbar spine or pelvis received multiple intrathecal injections of 0.5–1.5 mg morphine to produce pain relief for 18–84 hours. Expand
Postoperative pain relief using epidural morphine
In postoperative prostatectomy patients, morphine 2 mg in 10 ml 0·9% saline was given epidurally for pain relief and its effectiveness compared with bupivacaine and significant hypotension occurred in approximately 5% of the patients receiving bupvacaine, but was not seen following morphine. Expand
Respiratory Effects of Epidural Morphine
This clinical application of morphine is based on the works of Snyder, Yaksh and Rudy, which demonstrated specific opiate receptors that are distributed in the posterior horns of the spinal cord to use epidural morphine injections for postoperative pain relief. Expand
Postoperative Pain Therapy by Epidural Morphine
Epidural morphine was given to 50 patients after abdominal surgery to obtain a long analgesia and no pneumonia occurred postoperatively whereas 4 pneumonia were seen in a control group of 50 patients treated with intravenous analgetics. Expand
Epidural Opiate and Perioperative Analgesia
Epidural injections of 5 mg nicomorphine in 20 ml 5% glucose were given to 10 gynaecological patients to provide intra‐operative and post‐operative analgesia to suggest that opiates produce these effects by a direct action on the endorphin “pain” modulatory system of human beings at spinal level. Expand
Epidural opioids in the management of acute surgical pain
  • A. Wolf
  • Medicine
  • Journal of psychopharmacology
  • 1991
Epidural analgesia has now been used in obstetric practice for more than 40 years, but only in the last decade has it become an established technique for post-operative analgesia, reflecting the growing consumer demand for improved pain control after surgery. Expand
Experiences with epidular morphine in obstetrics
Morphine (2–6 mg) injected into the epidural space was ineffective in relieving the pain of labour in eight patients and a relatively high incident of postoperative vomiting was noted among the patients who received morphine. Expand


Clinical Observations Suggesting a Changing Site of Action during Induction and Recession of Spinal and Epidural Anesthesia
The cephalad borders of analgesia were determined 0.75 to 4 hours following the induction of spinal or lumbar epidural anesthesia. Levels thus obtained followed a straight line best described by theExpand
Local Anesthetic Drugs: Penetration from the Spinal Extradural Space into the Neuraxis
Local anesthetics, injected into the spinal extradural space, can be recovered from the spinal cord and brain, independent of an active circulation. Expand
In vivo comparison of the receptor populations acted upon in the spinal cord by morphine and pentapeptides in the production of analgesia
The main criterion relied on to assess the pharmacological identity of the receptor populations acted upon by both families of agonists (the opiates and the endogenous peptides) in the production of analgesia has been the antagonism of both by naloxone. Expand
Opiate receptors in the brain.
  • S. Snyder
  • Medicine
  • The New England journal of medicine
  • 1977
Opiates have had therapeutic relevance since antiquity and are still among the most widely used drugs in medical practice. The euphoric and calming actions of opiates fostered their clinical use as...
Opiate receptors and internal opiates.
Studies on the direct spinal action of narcotics in the production of analgesia in the rat.
  • T. Yaksh, T. Rudy
  • Medicine
  • The Journal of pharmacology and experimental therapeutics
  • 1977
  • Proc . Fedn . Am . Socs . exp . Biol .
  • 1976