Treatment of chronic cancer pain by means of continuous intrathecal low dose morphine administration with a totally implantable subcutaneous pump. Case report.

A 59 year old man suffering from intractable chronic pain from sacral coccygeal relapsing neoplasia with pelvic invasion, operated and irradiated more than once, after a first partial success with subarachnoid intermittent morphine infusion by means of a subcutaneous reservoir, refilled transcutaneously, has been treated with continuous intrathecal low-dose morphine infusion with a totally implantable pump. This device not only greatly resolves many of the problems connected to spinal administration of morphine, but it also allows to obtain constant concentrations of the drug, so that an efficacious therapeutic action is already present at low doses, reducing the risks of overdose and supraspinal redistribution as well as the development of tolerance. This case represents the first example in Italy of the use of a completely implantable pump for this purpose.