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Clinical differences in spinal opioid efficacy


The case report describes a patient who presented with two simultaneously-occurring but distinct pain syndromes. Epidural morphine controlled the pain from the abdominoperineal resection, while thepainfrom a deep venous thrombosis was not masked. Such differential effects of epidural morphine onpain of varying origin supports physiological observations on the specificity of the site of action of spinal opioids.


Voici l’histoire d’ une patiente souffrant simultanément de deux types de douleur distincts. Nous avons réussi à soulager la douleur causée par une résection abdomino-périnéale du rectum avec de la morphine par voie péridurale, sans toutefois occulter la douleur associée è une thrombophlébite profonde. L’effet sélectif de la morphine péridurale sur des douleurs d’ origines diverses peut trouver son explication dans l’ existence de plusieurs sites d’ action spécifiques au niveau rachidien.


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Correspondence to Slawomir Organowski.

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Organowski, S., Duncan, P.G. Clinical differences in spinal opioid efficacy. Can J Anaesth 36, 448 (1989).

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Key words

  • anaesthetic techniques: epidural, opiates
  • complications: thrombosis
  • pain: postoperative
  • pharmacology: narcotics, spinal
  • veins: thrombophlebitis