Irish journal of medical science
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A 61 year old female patient presented with metastatic bone pain three years post mastectomy. Standard oral analgesics and epidural morphine were ineffective in achieving pain control. Her pain was eventually controlled with morphine sulphate 48 mg daily via a self administered intrathecal pump. These devices are being used with increasing frequency and this case report highlights some of the problems encountered in this patient's management.
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Fifteen patients with intractable pain received intrathecal morphine delivered via a programmable (Medtronic) device. In twelve patients the pain was due to cancer and three patients had pain of non malignant origin. All of the patients reported excellent or good relief. ⋯ One patient with pain of non malignant origin developed serious complications which required the removal of the infusion device. The results of this study show that chronic intrathecal infusion of morphine is superior to conventional forms of analgesia in patients with intractable pain of malignant origin. We would advise that it should remain a therapy of last resort in patients with intractable non malignant pain as the long term side effects are still unknown and the potential for serious side effects still exists.