Epidural Administration of Morphine for Cancer Pain via Portal System

Yoon, Duck Mi; Chung, So Young; Oh, Hung Kun; Kim, Ju Yeon

Abstract

BACKGROUNDS: Efficacy of spinal opioids for the treatment of intractable cancer pain has been reported by several authors. The epidural route seems to be a more reliable and effective method of pain control as compared to the intrathecal route which can lead to serious complications. This study evaluated the results of long-term epidural use of opioids by portal system. METHOD: Medical records were reviewed of 18 patients who had been treated with epidural morphine via an implanted Port-A-Cath from Mar. 199l to Sep. l994.
RESULTS
Patients were treated for a mean of 92 days. There were wide variation of dose requirements. The minimum daily dose ranged from 2 to 10mg, and maximum daily dose from 3 to 30 mg. Verbal rating scale were below moderate until 1l0th days after portal implantation. When 3 patients suffered from aggravated pain associated with vertebral metastasis. Five of 11 patients who were administered medication longer than 50 days required increased doses ranging from 3mg to 25mg which were higher as compared to initial doses. These patients also experienced pain due to vertebral metastasis. There were no report of epidural scarring, respiratory depression, epidural infections, meningitis, or catheter blockade.
CONCLUSION
Continuous epidural morphine administration via Port-A-Cath is an effective method with minimal complication.