Abstract
Intraspinal morphine may provide analgesia by binding to opiate receptors in the dorsal horn of the spinal cord [1]. The intraspinal administration of morphine, either epidural or intrathecal, provides a very high concentration of morphine to the spinal cord. When the catheter is placed near that part of the spinal cord that mediates pain for a particular part of the body, a much higher level of morphine can be delivered to that part of the spinal cord than to other parts of the nervous system [2].
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Yaksh TL, Reddy SVR: Studies in the primate on the analgesic effects associated with intrathecal actions of opiates. A-adrenergic agonists and baclofen. Anesthesiology 54:451–467, 1981.
Moulin DE, Inturrisi CE, Foley KM: Epidural and intrathecal opioids: Cerebrospinal fluid and plasma pharmacokinetics in cancer pain patients. In: Advances in Pain Research and Therapy, Vol 8. Raven Press, New York, 1986, pp 369–383.
Harbaugh RE, Coombs DW, Saunders RL, Gaylor M, Pageau M: Implanted continuous epidural morphine infusion system. Preliminary report. J Neurosurg 56:803–806, 1982.
Coombs DW, Saunders RL, Gaylor MS, Block AR, Colton T, Harbaugh R, Pageau MG, Mroz W: Relief of continuous chronic pain by intraspinal narcotics infusion via an implanted reservoir. JAMA 250:2336–2339, 1983.
Coombs DW, Saunders RL: Intraspinal infusion of narcotic drugs. In: Neurosurgery, Wilkins RH, Rengachary SS, eds. McGraw-Hill, New York, 1985, pp 2390–2397.
Onofrio BM, Yaksh TL, Arnold PG: Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. Mayo Clin Proc 56:516–520, 1981.
Poletti CE, Cohen AM, Todd DP, Ojemann RG, Sweet WH, Zervas NT: Cancer pain relieved by long-term epidural morphine with permanent indwelling systems for self-administration. J Neurosurg 55:581–584, 1981.
Penn RD, Pake JA, Gottschalk W, Ivankovich AD: Cancer pain relief using chronic morphine infusion. Early experience with a programmable implanted drug pump. J Neurosurg 61:302–306, 1984.
Wang JK, Nauss LA, Thomas JE: Pain relief by intrathecally applied morphine in man. Anesthesiology 50:149–151, 1979.
Penn RD, Paice JA: Chronic intrathecal morphine for intractable pain. J Neurosurg 67:182–186, 1987.
Brazenor GA: Long-term intrathecal administration of morphine: A comparison of bolus injection via reservoir with continuous infusion by implanted pump. Neurosurgery 21:484–491, 1987.
Hadley MN, Shetter AG: Intrathecal opiate administration for analgesia. Contemp Neurosurg 8:1–5, 1986.
Jorgensen BC, Andersen HB, Engquist A: CSF and plasma morphine after epidural and intrathecal application. Anesthesiology 55: 714–715, 1981.
Magora F, Olshwang D, Eimerl D, Shorr J, Katzenelson R, Cotev S, Davidson JT: Observations on extradural morphine analgesia in various pain conditions. Br J Anaesth 52:247–252, 1980.
Erickson DL, Blacklock JB, Michaelson M, Sperling KB, Lo JN: Control of spasticity by inplantable continuous flow morphine pump. Neurosurgery 16:215–217, 1985.
Gustafsson LL, Schildt B, Jacobsen K: Adverse effects of extradural and intrathecal opiates: Report of a nationwide survey in Sweden. Br J Anaesth 54:479–486, 1982.
Samii K, Feret J, Hakari A, Viars P: Selective spinal analgesia. Lancet 1142, 1979.
Yaksh TL: Spinal opiate analgesia: Characteristics and principles of action. Pain 11: 293–346, 1981.
Krames ES, Wilkie DJ, Gershow J: Intrathecal D-Ala2-D-Leu5-enkephalin (DADL) restores analgesia in a patient analgesically tolerant to intrathecal morphine sulfate. Pain 24:205–209, 1986.
Stein C, Brechner T: Epidural morphine tolerance: Use of norepinephrine. Clin J Pain 2:267–269, 1987.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1989 Kluwer Academic Publishers
About this chapter
Cite this chapter
Brisman, R., Goodman, R.R. (1989). Intraspinal Morphine for Treatment of Chronic Noncancer Pain. In: Brisman, R. (eds) Neurosurgical and Medical Management of Pain: Trigeminal Neuralgia, Chronic Pain, and Cancer Pain. Topics in Neurosurgery, vol 3. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1651-0_17
Download citation
DOI: https://doi.org/10.1007/978-1-4613-1651-0_17
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-8917-3
Online ISBN: 978-1-4613-1651-0
eBook Packages: Springer Book Archive