title: Epidural and subcutaneous morphine in the management of cancer pain: a double-blind cross-over study.
abstract: Ten patients who suffered from severe cancer-related pain participated in a randomised, double-blind and cross-over study to compare the effectiveness and acceptability of epidural and subcutaneous administration of morphine. The patients titrated themselves pain-free in 48 h using a patient controlled analgesia system. The median daily doses calculated from the consumption of the last 4-h study period were 372 mg for subcutaneous and 106 mg for epidural administration. The two modes of morphine administration turned out to be comparable in terms of both effectiveness and acceptability. Both treatments provided better pain relief with less adverse effects compared with the prestudy oral morphine treatment.
authors.affiliation: Department of Anaesthesia, Helsinki University Central Hospital, Finland. eija.kalso@helsinki.fi
authors.forename: E
authors.initials: E
authors.lastname: Kalso
authors.forename: T
authors.initials: T
authors.lastname: Heiskanen
authors.forename: M
authors.initials: M
authors.lastname: Rantio
authors.forename: P H
authors.initials: PH
authors.lastname: Rosenberg
authors.forename: A
authors.initials: A
authors.lastname: Vainio
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001774:Blood Chemical Analysis; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D009022:Morphine Derivatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care
chemical_list: D000701:Analgesics, Opioid; D009022:Morphine Derivatives; C035349:morphine-6-glucuronide; D009020:Morphine; C018108:morphine-3-glucuronide