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Neuronal blockade with morphine. A hypothesis
Anaesthesia
|August 1, 1984
Summary
A brachial plexus block with morphine provided significant pain relief for a patient with Pancoast's tumour. This novel approach offered 36 hours of analgesia, suggesting a potential new method for managing intractable cancer pain.
Area of Science:
- Oncology
- Pain Medicine
- Neurology
Background:
- Pancoast's tumours can cause severe, intractable pain due to brachial plexus invasion.
- Standard opioid analgesia, such as subcutaneous morphine, may be insufficient for such pain.
Observation:
- A patient with a Pancoast tumour experienced unbearable pain despite receiving 180 mg of morphine subcutaneously daily.
- An interscalene brachial plexus block was administered using 5 mg of morphine hydrochloride in 10 ml of saline.
Findings:
- Complete pain relief (analgesia) was achieved within 20 minutes post-block.
- The analgesic effect persisted for 36 hours.
Implications:
- Local brachial plexus blockade with morphine may be an effective strategy for managing severe cancer-related neuropathic pain.
- The mechanism might involve neuro-axonal transport of morphine to the spinal cord.
- Further controlled trials are warranted to validate this therapeutic approach.