title: Intrathecal morphine pump for neuropathic cancer pain: a case report.
abstract: The WHO ladder has been the most widely used approach for management of Cancer Pain. However, oral medications alone may be inadequate, particularly in difficult to treat cancer pain syndromes. Neuropathic pain is one of these refractory syndromes. The role of opioids has always been controversial in pain of neuropathic origin. We report a case of a 61 year old female patient with endometrial carcinoma suffering from severe neuropathic pain in her left lower limb. The pain was refractory to highest tolerable doses of oral morphine and neuromodulator drugs, viz. gabapentin and pregabalin. We managed the patient successfully with intrathecal morphine pump reducing the total morphine dose and improving patient comfort and satisfaction. Intrathecal delivery of Morphine ensured better efficacy with fewer side effects.
authors.affiliation: Department of Anaesthesia, Pain and Palliative Care, IRCH, AIIMS, New Delhi, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Gogia
authors.forename: Prakash
authors.initials: P
authors.lastname: Chaudhary
authors.forename: Arif
authors.initials: A
authors.lastname: Ahmed
authors.forename: Deepa
authors.initials: D
authors.lastname: Khurana
authors.forename: Seema
authors.initials: S
authors.lastname: Mishra
authors.forename: Sushma
authors.initials: S
authors.lastname: Bhatnagar
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D016889:Endometrial Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D060186:Infusions, Spinal; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010148:Intractable Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine