Advertisement

Control of Spasticity with Intrathecal Morphine Sulfate

  • D. L. Erickson
  • P. Moreno
  • J. Lo
  • J. Cameron
  • M. Michaelson

Abstract

Spasticity due to spinal cord insult, can be controlled effectively in many patients with intrathecal morphine sulfate (M.S.). M.S. is known to produce analgesia by blocking A delta and C fiber synapses in the dorsal horn of the spinal cord. Morphine also interrupts the multisynaptic reflexes associated with stimulation of those same small fiber afferents, with no effect on the monosynaptic reflex and no direct effect on the lower motor neuron [1, 3, 4, 6, 8, 9, 11, 12]. It therefore seemed possible that intraspinal morphine might favorably effect spasticity at segmental levels without increasing paresis.

Keywords

Lower Motor Neuron Test Injection Intrathecal Morphine Fiber Synapse Spastic Quadriparesis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bodo RC, Brooks C (1937) The effect of morphine on blood sugar and reflex activity in the chronic spinal cat. J Pharmacol Exp Ther 61:82–88Google Scholar
  2. 2.
    Erickson DL, Blacklock JB, Michaelson MA, Sperling K, Lo JN (1985) Control of spasticity by implantable continuous flow morphine pump. Neurosurgery 16:215–217PubMedCrossRefGoogle Scholar
  3. 3.
    Irwin S, Houde RW, Bennett DR, Hendershot LC, Seevers MH (1950) The effects of morphine, methadone and meperidine on some reflex responses of spinal animals to nociceptive stimulation. J Pharmacol Exp Ther 101:132–143Google Scholar
  4. 4.
    Koll W, Haase J, Block G, Muhlberg B (1963) The predilective action of small doses of morphine on nociceptive spinal reflexes in low spinal cats. Int J Neuropharmacol 2:57–65CrossRefGoogle Scholar
  5. 5.
    Magora F, Olshwang D, Eimerl D, Shorr J, Katzenelson R, Cotev S, Davidson JT (1980) Observations on extradural morphine analgesia in various pain conditions. Br J Anaesth 52:247–252PubMedCrossRefGoogle Scholar
  6. 6.
    Martin WR, Eades CG, Fraser HF, Wiler A (1964) Use of hindlimb reflexes of the chronic spinal dog for comparing analgesics. J Pharmacol Exp Ther 144:8–11PubMedGoogle Scholar
  7. 7.
    Rawal N, Mollefors K, Axelsson K, Lingardh G, Widman B (1983) An experimental study of urodynamic effects of epidural morphine and of naloxone reversal. Anesth Analg 62:641–647PubMedCrossRefGoogle Scholar
  8. 8.
    Wikler A (1950) Sites and mechanisms of action of morphine and related drugs in the central nervous system. Pharmacol Rev 2:435–506Google Scholar
  9. 9.
    Yaksh TL (1981) Spinal opiate analgesia: characteristics and principles of action. Pain 11:293–346PubMedCrossRefGoogle Scholar
  10. 10.
    Yaksh TL, Reddy SVR (1980) Studies on the analgetic effects of intrathecal opiates, α-adrenergic agonists and baclofen: their pharmacology in the primate. Anesthesiology 54:451–467CrossRefGoogle Scholar
  11. 11.
    Yaksh TL, Rudy TA (1976) Analgesia mediated by a direct spinal action of narcotics. Science 192:1357–1358PubMedCrossRefGoogle Scholar
  12. 12.
    Yaksh TL, Rudy TA (1977) Studies on the direct spinal action of narcotics in the production of analgesia in the rat. J Pharmacol Exp Ther 202:411–428PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • D. L. Erickson
  • P. Moreno
  • J. Lo
  • J. Cameron
  • M. Michaelson

There are no affiliations available

Personalised recommendations