Continuous axillary brachial plexus analgesia with low dose morphine in patients with complex regional pain syndromes

In this prospective pilot study, nine patients suffering from complex regio nal pain syndrome of the arm were treated with morphine 0.16 mg h(-1) (3.84 mg day(-1)) applied continuously through an axillary brachial plexus cathe ter. In all of them an oral analgesic medication including the less potent opioid tramadol had not provided sufficient pain relief. During regional tr eatment, patients were kept in hospital and physiotherapy was carried out f requently in order to improve strength and function of the affected arm. Pa in at rest and during movement as well as grip strength were assessed at fi rst visit, during morphine infusion and at a long-term follow-up visit. All assessments improved significantly during plexus analgesia. There were no major opioid related side-effects. The results from this pilot study indica te that continuous axillary brachial plexus analgesia with low dose morphin e might be beneficial in patients suffering from complex regional pain synd rome of the arm.