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Pain unresponsive to high dose opiate drugs

Michael Sobell House, Mount Vernon Hospital, Northwood

Psb Russell

Michael Sobell House, Mount Vernon Hospital, Northwood

Rarely the pain from malignant disease, primary or metastatic, cannot be adequately relieved by conventional analgesics, even with very high dosage opiate drugs. It is now recognized that in many instances this pain, of deafferentation type, is due to actual nerve infiltration or destruction by tumour. Five such cases are reported, in each of whom, a different manipulation of drug therapy was necessary before adequate pain control was achieved. It is concluded that, until a better understanding of the mechanism of deafferentation pain is reached, treatment of such cases will remain unsatisfactory.

Key Words: diamorphine • intractable pain • morphine • opiates • palliative treatment

Palliative Medicine, Vol. 3, No. 1, 61-64 (1989)
DOI: 10.1177/026921638900300110


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