INTRAVENTRICULAR MORPHINE ADMINISTRATION AS THERAPEUTIC POSSIBILITY IN PATIENTS WITH INTRACTABLE PAIN

The treatment of intractable pain, especially in cancer patients, ofte n sets problems to patient and therapist. While epidural and intrathec al spinal administration of opiates is a routine treatment in pain wit h a sub-diaphragmatic topography it is almost ineffective in cervicoce phalic or thoracic cancer. An alternative here is the administration o f morphine into the lateral or third ventricle by a catheter-reservoir system. We report on our experience in the treatment of twenty patien ts, mostly suffering from cancer (18 cases), from 1990 to 1993. It is shown to be an effective, non-destructive method with minimal side eff ects in the treatment of nociceptive pain. Analgesia takes effect with in a few minutes and the necessary doses are low. Our results agree wi th those of other authors describing good to excellent results in 95% of patients with somatogenic pain. However, no or only minimal effect is achieved in the treatment of neurogenic pain by intracerebroventric ular morphine therapy.