Intrathecal and intraventricular morphine for pain in cancer patients: initial study

Leavens, Milam E.; Hill, C. Stratton; Cech, David A.; Weyland, J. B.; Weston, J. S.

doi:10.3171/jns.1982.56.2.0241

Cited by 128 publications

(45 citation statements)

References 10 publications

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“…Paradoxically, the risks of central respiratory depression are rela tively high after intraventricular administration of low doses of mor phine [6,7,12,14] and can be immediately reversed by naloxone. But all these patients have already received morphine systematically and as a result must have reduced sensitivity of opiate receptors [5,6,12].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal versus Intraventricular Chronic Opiate Administration with Implantable Drug Delivery Devices for Cancer Pain

Lazorthes¹,

Verdié²,

Bastide³

et al. 1985

Stereotact Funct Neurosurg

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Early publications have separately reported the efficacy, specificity and conservative character of direct spinal and intraventricular morphine analgesia in the treatment of intractable cancer pain. The objectives of this study are to compare efficacy and safety of these sites of local administration in order to determine the indication for each, the clinical effects of different opiates and the choice of various drug administration devices.

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Section: Discussionmentioning

confidence: 99%

“…But all these patients have already received morphine systematically and as a result must have reduced sensitivity of opiate receptors [5,6,12]. Mi nor and transient side effects, like nausea, vomiting, skin reactions and itching, occurred with the same rate in both [6,8].…”

Section: Discussionmentioning

confidence: 99%

Spinal versus Intraventricular Chronic Opiate Administration with Implantable Drug Delivery Devices for Cancer Pain

Lazorthes¹,

Verdié²,

Bastide³

et al. 1985

Stereotact Funct Neurosurg

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show abstract

“…Since Wang reported the administration of intrathecal morphine for pain relief in 1979, 24 There have been several applications of this technique for relief of both chronic, 25 and acute pain, 26,27,28 as well as for pain associated with labour. 29,30,31 Intrathecal morphine has been employed for postoperative analgesia in a wide range of doses, from 0.5 mg in patients after inguinal herniorrhapliy, 32 to 20 mg after laparotomy or thoracotomy 33 .…”

Section: Duration Of Analgesiamentioning

confidence: 99%

A Comparative Study Between Intrathecal Morphine and Intrathecal Buprenorphine for Post - Operative Analgesia Following Caesarian Section Under Sub Arachnoid Block

Varkey¹

2015

jemds

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BACKGROUND: Good pain relief following caesarian section is of great importance and intrathecal opioids provide good quality postoperative analgesia for longer duration. So the following study describes a comparative study between intrathecal morphine and intrathecal buprenorphine for postoperative pain relief following caesarian section (CS) under subarachnoid blockade. AIMS:The study was conducted to compare intrathecal morphine and buprenorphine for post of analgesia following CS, to achieve analgesia without sedation for better maternal child bondage and to popularize intrathecal opioids. MATERIALS AND METHODS: 60 patients posted for CS under SAB were randomly allocated into group A and group B of 30 each, the group A received morphine 0.1 mg and buprenorphine 0.03 mg was given for group B patients along with the local anaesthetic. Subjective assessment of post-operative analgesia was done by direct questioning of the patient and by a five point pain scores. Duration of analgesia was taken as the time interval between the time of injection of intrathecal opiate and the time at which the patient felt pain and requested for additional analgesics. Data's were analyzed using SPSS 16th version. OBSERVATION AND RESULTS: The mean duration of post-operative analgesia with intrathecal morphine was 24.19+4.8 hours and that with buprenorphine was only 11.7+3.28 hours. Over weight patients reported a lower mean duration of analgesia. None of the patients in the study showed any bradycardia, hypotension, desaturation or respiratory depression. Intrathecal opiates decreased the parenteral opiate requirements. The main side effects noticed were nausea in about 43% of patients in morphine group and 33% of patients in buprenorphine group. CONCLUSIONS: Intrathecal morphine 0.1 mg gives good post-operative analgesia of longer duration than buprenorphine 0.03mg. The quality of analgesia provided by intrathecal morphine was superior to intrathecal buprenorphine. There was no incidence of respiratory depression or sedation.

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“…The human application was promoted by the fact that direct IT morphine offered greater control of drug levels and rapid reversibility, produced fewer side effects, and offered superior pain control for certain refractory pain types. 4 In the early 1980s, Rico et al 5 and Leavens et al 6 both reported satisfactory analgesic effects with minimal side effects in patients treated with boluses of IT morphine. Both groups reported moderate to significant pain relief in a majority of the cancer patients studied (Rico et al, 78%; Leavens et al, and 66%), using individual IT injections of morphine.…”

Section: Intrathecal Pain Managementmentioning

confidence: 99%

Intrathecal Pumps

2008

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Summary: Direct neuroaxis drug delivery has expanded the physician's armamentarium to provide treatment options to those who have failed more conservative interventions. Starting from Bier's 'cocainization of the spinal cord' in 1898, direct nervous system pharmacy delivery has long been recognized as an effective means to treat pain. Intrathecal pump systems are now commonplace in the management of numerous pain states, as well as of neuromuscular sequelae of central nervous system injury. There has been much advancement in the physiologic and pharmacologic understanding of direct neuromodulation, providing a growing number of treatment options depending on the specific disease state. As well, surgical techniques and catheter systems have undergone refinements providing improved long-term safety and efficacy. We present a review of the historical evolution to current intrathecal therapies, as well as a dialog regarding patient selection, drug options, and side effects. Also, included is a discussion of surgical techniques, current delivery options and complications concerning pump placement.

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Intrathecal and intraventricular morphine for pain in cancer patients: initial study

Cited by 128 publications

References 10 publications

Spinal versus Intraventricular Chronic Opiate Administration with Implantable Drug Delivery Devices for Cancer Pain

Spinal versus Intraventricular Chronic Opiate Administration with Implantable Drug Delivery Devices for Cancer Pain

A Comparative Study Between Intrathecal Morphine and Intrathecal Buprenorphine for Post - Operative Analgesia Following Caesarian Section Under Sub Arachnoid Block

Intrathecal Pumps

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