title: Intrathecal morphine therapy related granulomas: two case reports.
abstract: Intrathecal morphine infusions have historically been used in patients with short life expectancies. More recently, patients with pain from a benign source have benefited from this therapy. While use in this population has been well documented and found to be relatively safe, new complications are being encountered secondary to the patients' longer life spans. The development of granulomatous masses from catheter use in intrathecal morphine therapy is an uncommon, but potentially serious problem. At West Virginia University Hospital, we have implanted more than 700 intrathecal drug delivery systems (IT-DDS) since 1989, and have encountered two cases of granulomatous masses developing at the tip of the intrathecal catheter. This report describes these illustrative cases and provides a review of the literature.
authors.affiliation: Dept. of Neurosurgery, West Virginia University School of Medicine, Morgantown, USA.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Miele
authors.forename: Kenneth
authors.initials: K
authors.lastname: Price
authors.forename: Stephen
authors.initials: S
authors.lastname: Bloomfield
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hogg
authors.forename: Julian
authors.initials: J
authors.lastname: Bailes
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems / Q000009:adverse effects*; D006099:Granuloma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010148:Intractable Pain / Q000188:drug therapy*; D013122:Spinal Diseases / Q000209:etiology* / Q000628:therapy
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine