Journal de la douleur et du soulagement

Abstrait

Intrathecal Morphine Therapy for Chronic Non-malignant Pain Using a Constant Flow Infusion System

Jairo Angelos, Martin Paiz, Christiane Pellegrino Rosa, Roberta Risso, Bernardo Monaco, Kleber Paiva Duarte, William Omar Contreras Lopez, Manoel Jacobsen Teixeira and Erich Talamoni Fonoff*

Background: Implantable pumps for intrathecal opioid therapy in the last decades emerged as one of the most effective treatment for chronic non-malignant pain (CNMP) in selected patients. This study analyses reliability of intrathecal infusion morphine therapy for chronic and refractory pain not related to malignancy using an implantable constant flow pump.

Methods: we studied eleven patients (9 women and 2 men; age range 26-67 years), with medically unresponsive CNMP. Pain was classified as neuropathic or non-neuropathic based on clinical features. Patients were evaluated before and after pump implantation, measuring pain intensity and relief after intrathecal opioid treatment based on Visual Analogic Scale (VAS) scores.

Results: Pain significantly reduced in almost all patients (91%); mean pain scores improved from 8.9 ± 1.49 before implant to 66% improvement one month after infusion therapy (3.1 ± 1.60) and 41% after 18 months (5.2 ± 2.45).

Conclusion: The present data show that intrathecal morphine infusion at a constant flow proved to be a safe and suitable alternative for the treatment of CNMP.