PMID: 7537316Feb 1, 1995Paper

Outcomes of epidural morphine treatment in cancer pain: nine years of clinical experience

Journal of Pain and Symptom Management
H SamuelssonT Hedner

Abstract

The outcome of epidural morphine therapy is described in 146 consecutive cancer patients who were treated by a community hospital-based pain service. The routine procedure used a standard epidural catheter that was tunneled subcutaneously. One hundred and twenty-one patients improved and stayed on lifelong or chronic epidural opioids. Mean treatment time was 92 days (median, 47; range, 2-2040); 49% of the time was spent as outpatients. Twenty-five patients failed to respond to the treatment. The oral daily morphine-equivalent dose prior to inclusion was 164 mg. The mean daily epidural start dose of morphine was 18 mg (range, 6-120), and the mean daily dose at termination was 69 mg (range, 2-540). The dose escalations, described as the ratio of the maximum dose to the minimum maintenance start dose, were moderate, with a mean of 4.1 (median, 2.5), which corresponded to a percent increase of 5.1 (median, 2.7) per patient per day. Lack of effect due to the character of the original symptoms or progression of pain was the main reason for withdrawal from epidural opioid therapy (N = 27), followed by catheter-related problems (N = 9) and drug-related complications (N = 5). Also due to drug-related complications, epidural morphine the...Continue Reading

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Citations

May 16, 2000·Journal of Biomedical Science·C A Fairbanks, G L Wilcox
Jan 24, 2009·Wiener medizinische Wochenschrift·Thomas Reif-Gintl, Wilfried Ilias
Aug 10, 2007·Current Pain and Headache Reports·Paul A Sloan
Sep 16, 2000·Journal of Pain and Symptom Management·G BennettT Yaksh
Sep 15, 1999·Journal of Pain and Symptom Management·D McIntoshN A Hagen
Dec 14, 2004·Journal of Palliative Medicine·Jay ThomasCharles F von Gunten
May 23, 2008·British Journal of Anaesthesia·W A Chambers
Jan 1, 2008·Neuromodulation : Journal of the International Neuromodulation Society·David J EllisUNKNOWN Elan Study 95-002 Group
Apr 28, 2010·Expert Review of Neurotherapeutics·Mandar Joshi, William A Chambers
Jun 2, 2012·Journal of Pain and Symptom Management·Akhila ReddyEduardo Bruera
Jun 29, 2011·Palliative Medicine·Geana Paula KuritaUNKNOWN European Palliative Care Research Collaborative (EPCRC)
Mar 17, 2009·Palliative Medicine·A K KnudsenS Kaasa
Sep 30, 2004·Palliative Medicine·Lisa BakerUNKNOWN Tyneside Spinals Group
Jun 11, 2002·Palliative Medicine·M A LeeW A Chambers
Sep 25, 2017·Pain Practice : the Official Journal of World Institute of Pain·Takashi YamaguchiKo Hisahara
Apr 16, 2002·International Journal of Palliative Nursing·R Day
Oct 29, 2013·The Cochrane Database of Systematic Reviews·Jane C BallantyneGanesan Baranidharan
Dec 29, 1998·The American Journal of Hospice & Palliative Care·S G Mercadante
Apr 2, 2004·The American Journal of Hospice & Palliative Care·Robert K SylvesterCaroline Schauer

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