Epidural morphine by continuous infusion with an external pump for pain management in oncology patients

Ten patients with advanced malignancies and severe pain were given epidural morphine (EDM) by continuous infusion. The pain had been treated previously with large doses of oral or parenteral narcotics, without success. The pain was disabling in all the cases. The total dose of morphine administered was 10-90 mg per day; median dose was 25 mg. Treatment lasted from 9 to 400 days. Pain relief was complete in seven patients, near complete in two, and moderate in one. Five patients became fully ambulatory. Two patients were treated as outpatients and resumed work activities. No central nervous system or gastrointestinal adverse effects, respiratory depression, or pruritus were noted. One patient developed urinary retention. EDM by continuous infusion produced constant pain relief for prolonged periods. This technique is safe for analgesia in oncology patients and suited for outpatient management.