Intrathecal morphine for pelvic and sacral pain caused by cancer

Intrathecal pumps for giving opioids in chronic pain: a systematic review.

“…The expectation that long-term implantation would lead to altered body image and to individual and family emotional problems is not well documented. In fact, Cobb and colleagues, 25 in a series of patients receiving intrathecal opioids for pelvic and sacral pain, noted that the help required with the administration of this therapy actually brought partners closer. • Overdose and abuse have been documented.…”

“…• pain refractory to conventional measures 25 • pain unrelieved by other methods 40 • pain totally dominating life 45 • inability to treat pain successfully 65 • inadequate pain relief 61 • inability to control pain in other ways. 24 The authors of a number of articles wrote generically of other techniques and routes being tried and found to be ineffective.…”

Spinal opioids in adult patients with cancer pain: A systematic review: A European Palliative Care Research Collaborative (EPCRC) Opioid Guidelines Project

“…Cases series also had small samples sizes, which were less than 20 patients in three studies. 50 – 52 The epidural route was used in one study 51 and the intrathecal in four studies 50,52 – 54 . The addition of bupivacaine to spinal opioids was described in one study, 51 and the use of implantable systems was described in four studies.…”

“…The addition of bupivacaine to spinal opioids was described in one study, 51 and the use of implantable systems was described in four studies. 50,52 – 54 Pain relief was classified by word categories in three studies 50,52,53 and percentage of relief and use of analgesics in one study. 54 The use of adjuvant analgesics by other routes was described in four studies 50,51,53,54 and side effects after spinal opioid treatment also in four studies.…”

“…50,52 – 54 Pain relief was classified by word categories in three studies 50,52,53 and percentage of relief and use of analgesics in one study. 54 The use of adjuvant analgesics by other routes was described in four studies 50,51,53,54 and side effects after spinal opioid treatment also in four studies. 50,52 – 54 These case series all indicated that spinal opioids improved pain relief in the majority of patients.…”