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Palliative Medicine
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Cancer pain and intrathecal morphine

Andres Gonzalez-Navarro

Pain Unit, Instituto Oncologico de Madrid

Tomas Molinero-Aparicio

Pain Unit, Instituto Oncologico de Madrid

Liliana Manzo

Pain Unit, Instituto Oncologico de Madrid

A total of 40 cancer patients suffering from chronic pain were treated with morphine by intrathecal administration through a subcutaneous implanted reservoir. All patients had been treated previously with other methods without good results. Pain evaluation was made using the visual analogue scale (VAS) and our INO scales. A morphine intrathecal test was made initially, to disclose if this method of administration would be effective.

The most frequent initial dose of morphine was 2mg/day and according to the pain relief, the dose was modified during the treatment. The tolerance phenomenon was present in our series but in a very large number of patients, the initial dose was maintained until the end of treatment.

Side effects were comparable with those described by other authors. Respiratory depression did not occur in our series. The most important complications consisted of infection in the nervous system. This method of treatment can alleviate pain in cancer patients, but should not be done routinely, only when other methods have failed.

Key Words: analgesia • morphine • neoplasm • pain • spinal canal • subarachnoid space

Palliative Medicine, Vol. 3, No. 4, 287-292 (1989)
DOI: 10.1177/026921638900300409
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D. Gorman
Review article : Opioid analgesics in the management of pain in patients with cancer: an update
Palliative Medicine, October 1, 1991; 5(4): 277 - 294.
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