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Prolonged release extradural morphine.

E C Howard, G R Murray, T N Calvey

    Annals of the Royal College of Surgeons of England
    |January 1, 1985
    PubMed
    Summary
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    Extradural Duromorph showed variable pain relief, with best results in postoperative pain patients. Slowed respiration occurred in some chronic pain patients, suggesting a local spinal cord effect.

    Area of Science:

    • Anesthesiology
    • Pharmacology
    • Pain Management

    Background:

    • Extradural administration of analgesics is used for pain management.
    • Microcrystalline morphine (Duromorph) is a preparation for extradural use.
    • Understanding Duromorph's efficacy and side effects is crucial for clinical application.

    Purpose of the Study:

    • To evaluate the effects of extradural Duromorph in patients with postoperative or malignant pain.
    • To assess the relationship between plasma morphine concentrations and pain relief.
    • To identify potential adverse effects of extradural Duromorph.

    Main Methods:

    • Studied 5 patients receiving extradural Duromorph.
    • Assessed pain using a visual analogue scale.
    • Monitored plasma morphine concentrations and respiratory rates.

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    Main Results:

    • Highly variable pain relief observed across patients.
    • Best analgesic effects were noted in patients with postoperative pain.
    • Two patients with malignant pain experienced slowed respiratory rates.
    • Plasma morphine concentrations exhibited a biphasic pattern.
    • Little correlation found between plasma morphine levels and pain relief.

    Conclusions:

    • Extradural Duromorph efficacy is variable, particularly in malignant pain.
    • Slowed respiration is a potential adverse effect in chronic pain patients.
    • The lack of correlation between plasma levels and pain relief suggests a local spinal cord mechanism of action for Duromorph.