We studied 29 patients in the final stage of head or neck cancer who were suffering pain that was not relieved by oral morphine. Cervical or thoracic epidural morphine was administered to relieve the pain. The quality of analgesia was equally good for both techniques. However, cervical epidural administration appeared to be superior, because much smaller doses of morphine were required in order to induce more rapid and longer analgesia.
CousinsMJMatherLE. Intrathecal and epidural administration of opioids. Anesthesiology1984;61: 276–310.
2.
YakshTL. Spinal opiates: a review of their effect on spinal function with an emphasis on pain processing. Acta Anaesthesiol ScandSuppl1987;85: 25–37.
3.
SmithDE. Spinal opioids in the home and hospice setting. J Pain Symptom Manage1990;5: 175–82.
4.
CrawfordMEAndersenHBAugustenborgG. Pain treatment on outpatient basis using extradural opiates: a Danish multicenter study comprising 105 patients. Pain1983;16: 41–7.
5.
HuskissonEL. Visual analogue scales. In: MelzackR, ed. Pain measurement and assessment. New York, NY: Raven Press, 1983: 33–7.
6.
JensenMPKarolyPBraverS. The measurement of clinical pain intensity: a comparison of six methods. Pain1986;27: 117–26.
7.
AtwehSKurahM. Autoradiographic localization of opiate receptors in rat brain. 1. Spinal cord and lower medulla. Brain Res1977;124: 53–67.
8.
BromagePRCamporesiEMDurantPACNielsenCH. Rostral spread of epidural morphine. Anesthesiology1982;56: 431–6.
9.
GourlayGKCherryDACousinsMJ. Cephalad migration of morphine in CSF following lumbar epidural administration in patients with cancer pain. Pain1985;23: 317–26.
10.
LarsenVHIversenAPChristiensenPAndersenPK. Postoperative pain treatment after upper abdominal surgery with epidural morphine at thoracic or lumbar level. Acta Anaesthesiol Scand1985;29: 566–71.
11.
SullivanSRCherryDA. Pain from an invasive facial tumor relieved by lumbar epidural morphine. Anesth Analg1987;66: 777–9.
12.
Du PenSLWilliamsAR. Management of patients receiving combined epidural morphine and bupivacaine for the treatment of cancer pain. J Pain Symptom Manage1992;7: 125–7.
