title: Intrathecal narcotics for relief of pain from head and neck cancer.
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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland.
authors.forename: P E
authors.initials: PE
authors.lastname: Andersen
authors.forename: J I
authors.initials: JI
authors.lastname: Cohen
authors.forename: E C
authors.initials: EC
authors.lastname: Everts
authors.forename: M D
authors.initials: MD
authors.lastname: Bedder
authors.forename: K J
authors.initials: KJ
authors.lastname: Burchiel
mesh_terms: D000698:Analgesia / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000503:physiopathology*; D006801:Humans; D015918:Infusion Pumps, Implantable; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D013131:Spine
chemical_list: D009020:Morphine