Document Detail


Long-term intrathecal infusion of morphine and morphine/bupivacaine mixtures in the treatment of cancer pain: a retrospective analysis of 51 cases.
MedLine Citation:
PMID:  8278204     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective analysis of 51 patients with cancer pain treated with a continuous i.t. morphine infusion through a tunnelled percutaneous catheter was undertaken. Because of insufficient pain relief with morphine only, 17 of these patients received a morphine/bupivacaine mixture. Pain relief subsequently improved significantly in 10 patients and a moderate improvement was present in 4 patients. An additional analgesic effect of bupivacaine was not shown in 3 patients with clinical signs of severe mental depression. Bupivacaine-induced side effects were absent below a daily dosage of 30 mg by continuous infusion. In all patients a gradual dose increment was observed. No serious complications, neurologic sequelae or meningitis occurred. It is concluded that long-term i.t. infusion of morphine through a tunnelled catheter can provide adequate pain relief in cancer patients with an acceptable risk-benefit ratio. The effects of long-term intrathecal co-administration of local anesthetics, especially bupivacaine, await further prospective evaluation.
Authors:
R T Van Dongen; B J Crul; M De Bock
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pain     Volume:  55     ISSN:  0304-3959     ISO Abbreviation:  Pain     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1994-02-08     Completed Date:  1994-02-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  119-23     Citation Subset:  IM    
Affiliation:
Institute for Anesthesiology and Pain Treatment, University Hospital Nijmegen, Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bupivacaine / administration & dosage,  adverse effects,  therapeutic use*
Catheterization / adverse effects
Drug Combinations
Female
Humans
Injections, Spinal
Male
Middle Aged
Morphine / administration & dosage,  adverse effects,  therapeutic use*
Neoplasms / complications*
Pain Measurement
Pain, Intractable / drug therapy*,  etiology
Retrospective Studies
Chemical
Reg. No./Substance:
0/Drug Combinations; 2180-92-9/Bupivacaine; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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