Subcutaneous Morphine Is Superior to Intrathecal Morphine for Pain Control in a Patient with Hypernephroma
This case report illustrates differences in analgesia quality and morphine consumption between an intrathecal infusion and the subcutaneous instillation of morphine in a cancer patient with hypernephroma. Superior analgesia was obtained with a 450 mg dose of subcutaneous morphine [i.e., visual analo...
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| Veröffentlicht in: | Journal of clinical anesthesia 1998-03, Vol.10 (2), p.163-165 |
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| container_title | Journal of clinical anesthesia |
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| creator | Devulder, Jacques E |
| description | This case report illustrates differences in analgesia quality and morphine consumption between an intrathecal infusion and the subcutaneous instillation of morphine in a cancer patient with hypernephroma. Superior analgesia was obtained with a 450 mg dose of subcutaneous morphine [i.e., visual analog scale (VAS) score 0/10] than with 10 mg intrathecal morphine/day administered at the thoracolumbar (twelfth dorsal vertebra) level (VAS score 2/10). If the instillation occurs at the lumbosacral level (between the last lumbar and the first sacral vertebra), a dosage of 70 mg morphine/day cannot induce the same pain relief as 450 mg subcutaneous morphine (VAS score 5/10 vs. 0/10). In some cancer patients, subcutaneous morphine offers superior pain control than intrathecal morphine. |
| doi_str_mv | 10.1016/S0952-8180(97)00262-6 |
| format | Article |
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Superior analgesia was obtained with a 450 mg dose of subcutaneous morphine [i.e., visual analog scale (VAS) score 0/10] than with 10 mg intrathecal morphine/day administered at the thoracolumbar (twelfth dorsal vertebra) level (VAS score 2/10). If the instillation occurs at the lumbosacral level (between the last lumbar and the first sacral vertebra), a dosage of 70 mg morphine/day cannot induce the same pain relief as 450 mg subcutaneous morphine (VAS score 5/10 vs. 0/10). 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In some cancer patients, subcutaneous morphine offers superior pain control than intrathecal morphine.</description><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Bulk flow</subject><subject>cancer pain</subject><subject>Carcinoma, Renal Cell - complications</subject><subject>Humans</subject><subject>Injections, Spinal</subject><subject>Injections, Subcutaneous</subject><subject>intrathecal</subject><subject>Kidney Neoplasms - complications</subject><subject>Male</subject><subject>Middle Aged</subject><subject>morphine</subject><subject>Morphine - administration & dosage</subject><subject>Morphine - therapeutic use</subject><subject>Pain - drug therapy</subject><subject>Pain - etiology</subject><subject>Pain Measurement</subject><subject>spinal catheter</subject><subject>subcutaneous</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMFqGzEQhkVpSZ20jxDQKbSHbSWtJa1OIZg2Njgk4PYsJO0sVlivNpK2IW8fOTbOsSeJ-f6ZYT6ELin5QQkVPzdEcVY1tCHflPxOCBOsEh_QjDayruacqY9odop8RucpPRJCCqBn6KzU54rwGXrcTNZN2QwQpoTvQhy3fgC8SngzjRB9iDgHvBpyNHkLzvTvma6wB-MHvAgFhx6XrymV7GHI-NnnLV6-lBkDjNsYduYL-tSZPsHX43uB_v7-9WexrNb3t6vFzbpytSC5khZYxyWwBizvGmWoaIS1Zj6XrWGtVbyuCQdbE2EaQajiDripWWOZ6wit6wt0dZg7xvA0Qcp655ODvj8cqaWSXApJS5Afgi6GlCJ0eox-Z-KLpkTvHes3x3ovUCup3xxrUfoujwsmu4P21HWUWvj1gUO58p-HqJMrThy0PoLLug3-PxteAS6pjME</recordid><startdate>19980301</startdate><enddate>19980301</enddate><creator>Devulder, Jacques E</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980301</creationdate><title>Subcutaneous Morphine Is Superior to Intrathecal Morphine for Pain Control in a Patient with Hypernephroma</title><author>Devulder, Jacques E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c360t-7be2f57e28eb5f89a1686bba447da2db953305eb306a860195ce5a328b2cf0133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Analgesics, Opioid - administration & dosage</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Bulk flow</topic><topic>cancer pain</topic><topic>Carcinoma, Renal Cell - complications</topic><topic>Humans</topic><topic>Injections, Spinal</topic><topic>Injections, Subcutaneous</topic><topic>intrathecal</topic><topic>Kidney Neoplasms - complications</topic><topic>Male</topic><topic>Middle Aged</topic><topic>morphine</topic><topic>Morphine - administration & dosage</topic><topic>Morphine - therapeutic use</topic><topic>Pain - drug therapy</topic><topic>Pain - etiology</topic><topic>Pain Measurement</topic><topic>spinal catheter</topic><topic>subcutaneous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Devulder, Jacques E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Devulder, Jacques E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subcutaneous Morphine Is Superior to Intrathecal Morphine for Pain Control in a Patient with Hypernephroma</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>1998-03-01</date><risdate>1998</risdate><volume>10</volume><issue>2</issue><spage>163</spage><epage>165</epage><pages>163-165</pages><issn>0952-8180</issn><eissn>1873-4529</eissn><abstract>This case report illustrates differences in analgesia quality and morphine consumption between an intrathecal infusion and the subcutaneous instillation of morphine in a cancer patient with hypernephroma. 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| ispartof | Journal of clinical anesthesia, 1998-03, Vol.10 (2), p.163-165 |
| issn | 0952-8180 1873-4529 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Analgesics, Opioid - administration & dosage Analgesics, Opioid - therapeutic use Bulk flow cancer pain Carcinoma, Renal Cell - complications Humans Injections, Spinal Injections, Subcutaneous intrathecal Kidney Neoplasms - complications Male Middle Aged morphine Morphine - administration & dosage Morphine - therapeutic use Pain - drug therapy Pain - etiology Pain Measurement spinal catheter subcutaneous |
| title | Subcutaneous Morphine Is Superior to Intrathecal Morphine for Pain Control in a Patient with Hypernephroma |
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