Intrathecal narcotics for relief of pain from head and neck cancer

Arch Otolaryngol Head Neck Surg. 1991 Nov;117(11):1277-80. doi: 10.1001/archotol.1991.01870230093015.

Abstract

We describe our experience with nine patients with head and neck pain of malignant origin who were treated with continuous low-dose intrathecal morphine via a lumbar catheter and implantable subcutaneous drug delivery pump. All patients had failed prior attempts at oral narcotic pain control due to either poor pain control or intolerable side effects. Using a visual analogue scale where the most severe pain is rated as 10 and no pain is rated as 0, the mean visual analogue scale was reduced from 7.6/10 (range, 5 to 10/10) before implantation to 1.9/10, 2.0/10, and 0.5/10 at 1 week, 1 month, and 2 months after implantation, respectively. Complications were acceptable. We conclude that intrathecal administration of morphine is a safe and effective means of pain control. This method deserves serious consideration in patients with intractable pain secondary to head and neck malignancy.

MeSH terms

  • Analgesia / methods*
  • Head and Neck Neoplasms / physiopathology*
  • Humans
  • Infusion Pumps, Implantable*
  • Morphine / administration & dosage*
  • Pain Measurement
  • Pain, Intractable / drug therapy*
  • Pain, Intractable / etiology
  • Retrospective Studies
  • Spine

Substances

  • Morphine