ORAL MORPHINE HYDROCHLORIDE AS AN ANALGESIC FOR INTRACTABLE PAIN DUE TO END-STAGE UROLOGIC CANCER

During the past 5 year period, oral morphine hydrochloride was administered to 31 cases with end-stage urologic cancer to eliminate their intractable pain. Initial dose, usually 20-30mg/day, was augmented every 2 days and given in divided dosis 6 times a day. Twenty-two cases (71%) were relived of their pain. The average dosis and administered period were 53mg/day and 74 days, respectively. Excluding 4 cases who were administered for more than 200 days, 51 days was the mean period when opium was nesessary. Although mild, constipation, vomiting, somnolency and illusion were noted as the side effects of opium. After achieving analgesia by this therapy, discontinuation or reduction of morphine hydrochloride was possible without any withdrawal symptom. There is no optimum dose of opium for cancer pain. Therefore, use of enough opium should not be hesitated. It is advisable to use sufficient opium to eradicate intractable pain due to end-stage urological cancer during the final 50 days of their life and let the patient die in peace.