Intraventricular administration of morphine for control of intractable cancer pain in 90 patients.
OBJECTIVE
To quantitate the relief of intractable cancer pain by the use of intraventricular morphine administration.


METHODS
Intraventricular morphine administration was performed through an Ommaya reservoir. An initial dose of 0.25 mg of morphine sulfate per 24 hours was administered to all of the patients. This dose was progressively increased in 0.25-mg increments until optimal analgesia was attained.


RESULTS
Sixty men and 30 women with a median age of 58 years (range, 23-80 yr) entered the study. The median duration of pain was 6 months (range, 0.5-120 mo). A daily morphine dose of up to 1 mg was adequate to achieve an analgesic effect in 77% of the patients. Only nine patients (10%) achieved < 50% pain relief. Using a multiple regression analysis, only the morphine dosage was found to be an independent prognostic factor. The most frequent side effect (22%) was nausea/vomiting. Also, there were two patients with opioid intolerance and two with intracerebral hematomas. Three reservoirs failed.


CONCLUSIONS
Intraventricular morphine administration is a useful method for palliation of intractable cancer pain.
Karavelis
A
A
Department of Neurosurgery, AHEPA Hospital, Aristotle University of Thessaloniki, Macedonia, Greece.
Foroglou
G
G
Selviaridis
P
P
Fountzilas
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007276:Injections, Intraventricular / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009369:Neoplasms / Q000503:physiopathology*; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy*; D011788:Quality of Life
D000701:Analgesics, Opioid; D009020:Morphine