Epidural morphine for outpatients with severe anginal pain

Area of Science:

• Cardiology
• Pain Management
• Neurosurgery

Background:

• Chronic coronary artery disease (CAD) significantly impacts quality of life.
• Coronary artery bypass surgery (CABS) is a common treatment for advanced CAD.
• Persistent angina despite optimal medical therapy presents a therapeutic challenge.

Purpose of the Study:

• To evaluate the efficacy of epidural analgesia using morphine for refractory angina.
• To assess the feasibility of patient-controlled epidural morphine administration.

Main Methods:

• Implantation of subcutaneous epidural analgesia systems in seven patients with chronic CAD and post-CABS angina.
• Initiation of treatment with epidural morphine, self-administered by patients or family.
• Median observation period of four months (range 3-11 months).

Main Results:

• All seven patients experienced complete freedom from anginal pain during the treatment period.
• The epidural morphine treatment was well-tolerated by all patients.
• Self-administration of epidural morphine proved feasible for patients and their families.

Conclusions:

• Epidural morphine offers a viable and effective treatment option for refractory angina in patients with chronic CAD post-CABS.
• Patient-controlled epidural analgesia can successfully manage severe, persistent chest pain.
• This approach significantly improves the quality of life for patients with intractable angina.