Dennis G C, DeWitty R
J Natl Med Assoc. 1987 Sep;79(9):939-44.
Ten patients underwent implantation of intrathecal morphine catheters with subcutaneous implantation of morphine Infusaid pumps for the treatment of intractable pain of malignant origin from May 1984 to October 1985. All patients exhibited a good initial response to intrathecal morphine and developed some degree of tolerance. All patients with bony metastasis and/or lumbarsacral plexopathy developed rapid tolerance.Depressive illness was noted in all patients undergoing a psychiatric evaluation prior to institution of morphine infusion therapy. Seventy percent of patients treated could be treated on an outpatient basis after pump implantation.Complications included a pump pocket infection requiring the removal of the implanted system. There was no pump failure, respiratory depression, urinary retention, or mortality related to the use of the morphine infusion system. It is recommended that intrathecal morphine infusion be instituted when narcotics have been identified as necessary for pain relief, before the development of significant systemic tolerance.
1984年5月至1985年10月，10例患者接受了鞘内吗啡导管植入术，并皮下植入吗啡输注泵，用于治疗恶性肿瘤引起的顽固性疼痛。所有患者对鞘内吗啡均有良好的初始反应，并出现了一定程度的耐受性。所有有骨转移和/或腰骶丛病变的患者均迅速产生耐受性。在开始吗啡输注治疗前接受精神评估的所有患者中均发现有抑郁性疾病。70%接受治疗的患者在植入泵后可在门诊接受治疗。并发症包括泵袋感染，需要移除植入系统。未发生与使用吗啡输注系统相关的泵故障、呼吸抑制、尿潴留或死亡。建议在确定疼痛缓解需要使用麻醉药品时，在出现明显的全身耐受性之前开始鞘内吗啡输注。
