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November 1991

Intrathecal Narcotics for Relief of Pain From Head and Neck Cancer

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery (Drs Andersen, Cohen, and Everts) and the Division of Neurosurgery, Department of Surgery (Dr Burchiel), Oregon Health Sciences University, and the Department of Anesthesiology, St Vincent Hospital (Dr Bedder), Portland, Ore.

Arch Otolaryngol Head Neck Surg. 1991;117(11):1277-1280. doi:10.1001/archotol.1991.01870230093015

• We describe our experience with nine patients with head and neck pain of malignant origin who were treated with continuous low-dose intrathecal morphine via a lumbar catheter and implantable subcutaneous drug delivery pump. All patients had failed prior attempts at oral narcotic pain control due to either poor pain control or intolerable side effects. Using a visual analogue scale where the most severe pain is rated as 10 and no pain is rated as 0, the mean visual analogue scale was reduced from 7.6/10 (range, 5 to 10/10) before implantation to 1.9/10, 2.0/10, and 0.5/10 at 1 week, 1 month, and 2 months after implantation, respectively. Complications were acceptable. We conclude that intrathecal administration of morphine is a safe and effective means of pain control. This method deserves serious consideration in patients with intractable pain secondary to head and neck malignancy.

(Arch Otolaryngol Head Neck Surg. 1991;117:1277-1280)