[Intrathecal morphine therapy in children with cancer]

Five children with cancer pain were given continuous intrathecal morphine or fentanyl infusion associated with bupivacaine 0.25% without epinephrine. The morphine daily dose varied from 0.1 mg.kg-1 to 1 mg.kg-1, the maximum daily dose of fentanyl was 0.1 mg.kg-1 associated with the same dose of intravenous fentanyl, and the maximum daily dose of bupivacaine was 1 mg.kg-1. Intrathecal treatment was started after oral and epidural morphine treatment had failed. The children were at home, under the care of several nurses and physicians. A satisfactory analgesia was achieved until demise occurred. In all children, urinary retention was the only side effect of the therapy. Therefore, intrathecal opioid and bupivacaine may be indicated after oral morphine therapy has failed in children with advanced cancer refractory pain.