J Korean Pain Soc.  1992 May;5(1):29-36.

Effects of the Mixture of Morphine, Bupivacaine and Antidepressants by Continuous Epidural Infusion in Cancer and Non-cancer Pain

• Shin HC
• Kim JS
• Kim IH
• Song HB
• Ok SY
• Hwang KH
• Park W
• Kim SY

Abstract

This study was objected to evaluate clinical progressions about both the degree of pain relief and the occurrence of morphine tolerance while the epidural analgesia with low dose of morphine, bupivacaine and antidepressant continued repeatedly at every 5 day intervals of the constantrate infusion (0.5 ml/hr, 60 ml capacity). The subjects were divided to 56 cancer and 36 non-cancer patients who failed to respond to palliative treatments. Before the relief of pain, the pain severity was moderate (10%) and severe (90%). The dose escalation of morphine noted to 1l (20%)patients in cancer pain and to one (5%) case only in non-cancer. During the epidural analgesia, the effect of pain relief was moderate (11%) and good (89%) It suggest that the morphine tolerance may be reduced to some degree such as an initial minimum dose of epidural morphine with local anesthetic and antidepressant should be adjusted on an individual basis using the constantrate infusor, even though rapid dose escalation occurrs in some patients who the diseases progress over a short period of time.

MeSH Terms

Analgesia, Epidural
Antidepressive Agents*
Bupivacaine*
Humans
Infusion Pumps
Morphine*
Palliative Care
Antidepressive Agents
Bupivacaine
Morphine