title: [Treatment of extreme tumour pain with morphine and s-ketamine A case report of an 11-year old girl].
abstract: We are reporting on the case of an 11-year old girl with a malignant tumour. The extreme pain throughout the body could not be treated by conventional methods. By intravenous application of a morphine and s-ketamine mixture we were able to achieve a very effective analgesic result. Apart from the opiate effect of the morphine the decisive factor was the NMDA-antagonism of the s-ketamine. The latter suppresses central sensitisation and chronic pain and reduces or even prevents the development of opioid tolerance. It was possible to use smaller opiate doses more effectively, thus reducing the side effects of the pain therapy. Under associated whole-body thermochemotherapy the girl experienced general pain relief and we were able to return to conventional therapy with a fentanyl plaster.
authors.affiliation: Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universität Leipzig. lauferm@medizin.uni-leipzig.de
authors.forename: M
authors.initials: M
authors.lastname: Laufer
authors.forename: P
authors.initials: P
authors.lastname: Schippel
authors.forename: L
authors.initials: L
authors.lastname: Wild
authors.forename: D
authors.initials: D
authors.lastname: Olthoff
mesh_terms: D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007260:Infusion Pumps; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D010147:Pain Measurement; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D007649:Ketamine; D009020:Morphine; D016190:Carboplatin