Titre
Morphine péridurale dans les douleurs cancéreuses rebelles. Moyens et obstacles [Peridural morphine in intractable cancer pains. Means and obstacles]
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Bayer-Berger, M.M.
Auteure/Auteur
Arnér, S.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0750-7658
Statut éditorial
Publié
Date de publication
1985
Volume
4
Numéro
4
Première page
343
Dernière page/numéro d’article
350
Peer-reviewed
Oui
Langue
français
Résumé
Long-term analgesia with epidural morphine (EM) is a new tool in the management of intractable cancer pain. Twenty-six out of 160 cancer patients referred to the Pain Division for pain assessment were selected for analgesia with long-term epidural morphine, so aiming to define its place amongst more traditional methods of treatment, such as drugs, nerve-blocks, neurosurgery or radiotherapy. All 26 patients were cases of conventional analgesic failure, with very advanced cancer states. Thirteen patients became absolutely pain free throughout the treatment period: five of them were even allowed home. Another ten patients were satisfied with EM, though some residual pain of neurogenic and visceral type persisted. In three patients, epidural morphine was judged as a complete failure. The 134 other patients could be managed with either of the other above mentioned techniques. The most important selection criterion for patients requiring epidural morphine seemed to be continuous multiple site bilateral pain of deep somatic origin. The response was variable in continuous visceral pain, while neurogenic, cutaneous and intermittent pain due to intestinal obstruction responded only exceptionally. EM was most valuable in terminal situations when systemic opiates failed to give satisfactory analgesia, or in acute transitory situations, while waiting for a response to cancer-orientated therapy. Epidural morphine considerably improved the patients' quality of life, compared with conventional methods tried beforehand. Analgesic methods in cancer are palliative procedures. In terminal or temporary situations, other more invasive methods are not suited. The EM technique is simple, adjustable to advancing pain and has few side-effects, especially when compared with neurolytic and neurosurgical procedures.
PID Serval
serval:BIB_E1AC23B95FA8
PMID
Date de création
2008-01-21T16:30:48.033Z
Date de création dans IRIS
2025-05-21T05:15:00Z