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Pain management with spinally administered opioids.

R S Finley1

  • 1Department of Clinical Pharmacy, University of Maryland Cancer Center, Baltimore 21201.

American Journal of Hospital Pharmacy
|August 1, 1990
PubMed
Summary
This summary is machine-generated.

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Spinal opioids effectively manage severe chronic pain by acting on the central nervous system. This approach is ideal for patients with intractable pain unresponsive to conventional treatments.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Pain Management

Background:

  • Opioid receptors in the substantia gelatinosa mediate central pain control.
  • Spinal opioid administration targets pain originating below cranial nerves.

Purpose of the Study:

  • To discuss the efficacy and safety of spinally administered opioids for pain management.
  • To identify suitable candidates and optimal dosing for spinal opioid therapy.

Main Methods:

  • Review of spinally administered opioid therapy for chronic pain.
  • Discussion of patient selection criteria, including failure of conventional therapy or severe adverse effects.
  • Consideration of initial dosing (e.g., 1 mg morphine sulfate intrathecally) and factors influencing dosage requirements.

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Main Results:

  • Spinal opioids are effective for intractable midline sacral and perineal pain.
  • Preservative-free formulations allow for safe and comfortable administration of larger doses.
  • Potential for increased dosage needs due to tolerance, disease progression, or catheter issues.

Conclusions:

  • Spinal opioids offer an effective, safe, and comfortable method for managing severe chronic pain.
  • Careful management is required when discontinuing spinal opioid therapy.
  • Adjuvant therapies and potential adverse effects (e.g., respiratory depression, sedation) must be considered.