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Epidural morphine for postherpetic neuralgia

J W Watt1, J R Wiles, D R Bowsher

  • 1Pain Relief Foundation, Liverpool.

Anaesthesia
|July 1, 1996
PubMed
Summary

Epidural morphine provided limited pain relief for postherpetic neuralgia patients. Most experienced opioid side effects, while some achieved lasting relief with placebo, suggesting limited efficacy for epidural morphine in this condition.

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Area of Science:

  • Neurology
  • Pain Management
  • Pharmacology

Background:

  • Postherpetic neuralgia is a chronic pain condition often unresponsive to standard treatments like antidepressants.
  • Effective pain management strategies for postherpetic neuralgia remain a significant clinical challenge.

Purpose of the Study:

  • To evaluate the efficacy and safety of epidural morphine for managing established postherpetic neuralgia pain.
  • To compare epidural morphine's effectiveness against placebo in patients refractory to antidepressant therapy.

Main Methods:

  • A single-blind, placebo-controlled study involving eleven patients with postherpetic neuralgia.
  • Administration of epidural morphine (0.5 mg) and placebo to assess pain reduction and side effects.

Main Results:

  • Two patients experienced >50% pain reduction with epidural morphine, lasting 36-72 hours.
  • Six patients receiving morphine reported opioid-related side effects without pain relief.
  • Three patients achieved significant, long-lasting pain relief with placebo alone, with two maintaining benefit for over 6 months.

Conclusions:

  • Epidural morphine appears to offer limited pain relief for postherpetic neuralgia and is associated with a high incidence of opioid-related side effects.
  • Placebo treatment demonstrated notable effectiveness in a subset of patients, highlighting the complex nature of postherpetic neuralgia pain.

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