INTRAVENTRICULAR ADMINISTRATION OF MORPHINE FOR CONTROL OF INTRACTABLE CANCER PAIN IN 90 PATIENTS

OBJECTIVE: To quantitate the relief of intractable cancer pain by the use of intraventricular morphine administration. METHODS: Intraventric ular morphine administration was performed through an Ommaya reservoir . An initial dose of 0.25 mg of morphine sulfate per 24 hours was admi nistered to all of the patients. This dose was progressively increased in 0.25-mg increments until optimal analgesia was attained. RESULTS: Sixty men and 30 women with a median age of 58 years (range, 23-80 yr) entered the study. The median duration of pain was 6 months (range, 0 .5-120 mo). A daily morphine dose of up to 1 mg was adequate to achiev e an analgesic effect in 77% of the patients. Only nine patients (10%) achieved < 50% pain relief. Using a multiple regression analysis, onl y the morphine dosage was found to be an independent prognostic factor . The most frequent side effect (22%) was nausea/vomiting. Also, there were two patients with opioid intolerance and two with intracerebral hematomas. Three reservoirs failed. CONCLUSION: Intraventricular morph ine administration is a useful method for palliation of intractable ca ncer pain.