Subcutaneous morphine is superior to intrathecal morphine for pain control in a patient with hypernephroma

Journal of Clinical Anesthesia
J Devulder

Abstract

This case report illustrates differences in analgesia quality and morphine consumption between an intrathecal infusion and the subcutaneous instillation of morphine in a cancer patient with hypernephroma. Superior analgesia was obtained with a 450 mg dose of subcutaneous morphine [i.e., visual analog scale (VAS) score 0/10] than with 10 mg intrathecal morphine/day administered at the thoracolumbar (twelfth dorsal vertebra) level (VAS score 2/10). If the instillation occurs at the lumbosacral level (between the last lumbar and the first sacral vertebra), a dosage of 70 mg morphine/day cannot induce the same pain relief as 450 mg subcutaneous morphine (VAS score 5/10 vs. 0/10). In some cancer patients, subcutaneous morphine offers superior pain control than intrathecal morphine.

References

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Citations

Sep 16, 2000·Journal of Pain and Symptom Management·G BennettT Yaksh
Sep 16, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Allen W BurtonJames F Arens
Apr 1, 2008·Neuromodulation : Journal of the International Neuromodulation Society·Philip CorradoMichelle Wright
Oct 27, 2010·Brazilian Dental Journal·Marcelo Oliveira MazzettoRenata Campi de Andrade Pizzo

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