title: Diazepam as an adjuvant analgesic to morphine for pain due to skeletal muscle spasm.
abstract: Side effects of morphine are common when it is given in titrated doses to control severe pain in advanced cancer. We describe a case of severe back pain resistant to parenteral morphine accompanied by muscle spasm, in which the addition of diazepam both had an opioid-sparing effect and provided superior symptomatic relief. Diazepam appears to have a specific role as an adjuvant analgesic for pain due to skeletal muscle spasm associated with painful vertebral metastases.
authors.affiliation: The Harry R Horvitz Center for Palliative Medicine, Department of Hematology and Medical Oncology, 9500 Euclid Avenue, M-76, Cleveland, OH 44195, USA.
authors.forename: Manish
authors.initials: M
authors.lastname: Srivastava
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
mesh_terms: D001416:Back Pain / Q000188:drug therapy* / Q000209:etiology*; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D003975:Diazepam / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000494:pharmacology*; D018482:Muscle, Skeletal / Q000473:pathology; D013035:Spasm / Q000150:complications* / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary*
chemical_list: D009125:Muscle Relaxants, Central; D003975:Diazepam