Objective: To record the daily morphine doses, the influence of the treatment on quality of life and the incidence of side-effects and complications of continuous intrathecal morphine administration.
Setting: Academic Hospital, Free University, Amsterdam.
Design: Prospective.
Methods: Forty terminal patients with intractable cancer pain, who had either insufficient pain relief or severe side effects from systemic analgesics were selected for continuous intrathecal administration of morphine. An intrathecal catheter was implanted, tunnelled and connected with a portable infusion pump delivering morphine constantly and if needed on demand. In a pain diary the patients recorded: the number of daily doses of morphine, concomitant medication, pain scores on a visual analogue scale (VAS), extra doses and activities.
Results: The total number of catheter days was 1486. Patients were treated for a mean of 37.2 (range 2-183) days. The mean dose of daily administered morphine was in 30 patients (75%) less than 20 mg. Sufficient pain relief (VAS score < 5) was achieved in 37 patients (92.5%). Three patients had pain due to spinal cord compression, hardly responding to intrathecal morphine. Withdrawal symptoms, post-puncture headache and leakage of fluid could been treated conservatively. The catheter was removed inadvertently 6 times and could be replaced on outpatient basis. Meningitis occurred in 2 patients, who were adequately treated with antibiotics. The catheter could be re-inserted within 10 days.
Conclusion: In terminally ill cancer patients, the continuous intrathecal administration of morphine may be recommended if conventional pain relief fails.
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Eur J Anaesthesiol
January 2025
From the Department of Anaesthesiology, Wilhelmina Children's Hospital (OFCvdB, SR, LvB, WB), Pain Clinic, Department of Anaesthesiology (MR), Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (TPS) and Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA (PS).
Background: Optimising a mother's quality of recovery following caesarean delivery is of paramount importance as it facilitates maternal care of the newborn and affects physical, psychological and emotional well being. Intrathecal morphine (ITM) reduces postoperative pain and may improve quality of recovery: however its widespread use is limited.
Objective: To assess the effects of implementing ITM for caesarean delivery on postoperative quality of recovery.
Ann Phys Rehabil Med
January 2025
Department of Neurological Physical Medicine and Rehabilitation, St Jacques Hospital, University Hospital of Nantes, 44093 Nantes, France; Laboratory Movement-Interactions-Performance (MIP), EA 4334, University of Nantes, 44322 Nantes, France. Electronic address:
Background: Intrathecal baclofen (ITB) therapy effectively reduces severe spasticity but is associated with complications that can be serious. The evolution of these complications over time and their predictive factors are not well known.
Objectives: The primary aim was to describe the incidence of ITB complications in adults with neurological disorders and disabling spasticity.
Pharmaceuticals (Basel)
December 2024
Department of Anesthesiology, Cathay General Hospital, Taipei 106, Taiwan.
Background: Morphine analgesic tolerance (MAT) limits the clinical application of morphine in the management of chronic pain. IIK7 is a melatonin type 2 (MT2) receptor agonist known to have antioxidant properties. Oxidative stress is recognized as a critical factor in MAT.
View Article and Find Full Text PDFNeuropharmacology
March 2025
The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University/The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China; Department of Anesthesiology and Pain Research Center, Jiaxing University Affiliated Hospital, The First Hospital of Jiaxing, Jiaxing, Zhejiang, 314001, China. Electronic address:
Bone cancer pain (BCP) is one of the most severe complications faced by patients with cancer; however, current pharmacological options are limited. Curcumin has been demonstrated to possess anti-inflammatory and analgesic properties; however, our preliminary research found that the analgesic efficiency of curcumin is not high in BCP. Consequently, curcumin analogs have emerged as a significant focus of our research.
View Article and Find Full Text PDFPain Manag Nurs
November 2024
Department of Pain Management, Affiliated Hospital of Jiangnan University, Wuxi, China; Department of Internal Medicine, Affiliated Hospital of Jiangnan University, Wuxi, China. Electronic address:
Background: Intrathecal morphine pump helps alleviate pain in the advanced stages of cancer, and thus, ensuring safe intrathecal morphine pump infusion is important. In this study, we investigated the effect of healthcare failure mode and effects analysis (HFMEA) in the management of patients with intrathecal morphine pump implantation.
Methods: We included 112 cancer patients with severe pain who met the inclusion criteria for intrathecal morphine pump implantation treatment in the pain department of our hospital from November 2021 to October 2022.
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