Continuous intrathecal hydromorphone and clonidine for intractable cancer pain

The use of hydromorphone and clonidine, delivered intrathecally by an implanted infusion pump, is described in a patient with intractable cancer pain. The patient was a 48-year-old woman with uterine cervical cancer-related pain that was poorly responsive to conventional oral narcotics. Hydromorphone was used because of the patient's history of morphine intolerance. When progressive intrathecal hydromorphone dosages were required, intrathecal clonidine (an alpha 2 adrenergic agonist) was infused concomitantly. Intrathecal hydromorphone and clonidine successfully controlled this patient's pain without the necessity to resort to destructive neurosurgery.