Intrathecal morphine and bupivacaine in advanced cancer pain patients implanted at home

Fifteen patients with pain due to advanced cancer who no longer obtained relief from conventional treatment using oral or parenteral opioids were administered morphine and bupivacaine by continuous intrathecal infusion. Thirteen patients were implanted at home due to poor medical condition or refusal to be hospitalized. A summary score was derived to monitor the effects of the treatment. Thirteen patients required low doses of intrathecal morphine and bupivacaine and all reported good pain relief until death. Only minor side effects were evidenced. Implantation at home of an intrathecal catheter to administer morphine and bupivacaine provided a degree of pain relief during the last days of life that would have otherwise been impossible and did so without producing important complications.