• J Clin Anesth · Mar 1998

    Case Reports

    Subcutaneous morphine is superior to intrathecal morphine for pain control in a patient with hypernephroma.

    • J E Devulder.
    • Department of Anaesthesia-Section Pain Clinic, University Hospital of Ghent, Belgium.
    • J Clin Anesth. 1998 Mar 1;10(2):163-5.

    AbstractThis case report illustrates differences in analgesia quality and morphine consumption between an intrathecal infusion and the subcutaneous instillation of morphine in a cancer patient with hypernephroma. Superior analgesia was obtained with a 450 mg dose of subcutaneous morphine [i.e., visual analog scale (VAS) score 0/10] than with 10 mg intrathecal morphine/day administered at the thoracolumbar (twelfth dorsal vertebra) level (VAS score 2/10). If the instillation occurs at the lumbosacral level (between the last lumbar and the first sacral vertebra), a dosage of 70 mg morphine/day cannot induce the same pain relief as 450 mg subcutaneous morphine (VAS score 5/10 vs. 0/10). In some cancer patients, subcutaneous morphine offers superior pain control than intrathecal morphine.

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