title: The control of severe cancer pain by continuous intrathecal infusion and patient controlled intrathecal analgesia with morphine, bupivacaine and clonidine.
abstract: The management of severe cancer pain may be problematic in spite of recent advances in pain management. A small percentage of patients with severe intractable pain and/or intractable side effects may require more aggressive interventional pain management strategies including the administration of medications continuously by the intrathecal route. A variety of medications, including morphine, bupivacaine, and clonidine, may be used intrathecally for the control of cancer pain. Optimal use of these medications requires individual titration to the patient's needs. We describe a case of severe cancer pain where these medications were used successfully by continuous intrathecal infusion and patient controlled intrathecal analgesia.
authors.affiliation: Pain Service and Department of Anesthesiology, University of Washington, School of Medicine, Box 356540, Seattle, WA 98195, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Tumber
authors.forename: Dermot R
authors.initials: DR
authors.lastname: Fitzgibbon
mesh_terms: D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage* / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use; D002817:Chordoma / Q000188:drug therapy*; D003000:Clonidine / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007260:Infusion Pumps; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use; D010166:Palliative Care; D012445:Sacrococcygeal Region; D013125:Spinal Neoplasms / Q000188:drug therapy*
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D003000:Clonidine; D002045:Bupivacaine