Why to use subarachnoid microdoses of morphine chlor. In cancer pain

INTRATBECBAL BUPRENORPHINE FOR PAINFUL MUSCLE SPASMS IN PARAPLEGIC PATIENTS. C.J. Glynn , H.J. Mcy 5. Lloyd R.A. Moore* , P.J. Teddy* . Pain Relief Unit, Abingdon pital, Abingdon, Oxon , Nuffield Depts. of Anaesthetics , Clinical Biochemistry , & Neurosurgery, Radcliffe Infirmary, Oxford, U.K. The treatment of painful muscle spasms in paraAim of Investigation: plegic patients is difficult, as the classical anti spasmodics do not work in all patients. Intrathecal buprenorphine completely relieved the painful The study examines the role of bupremuscle spasm in a paraplegic patient. norphine in the treatment of painful muscle spasms in paraplegic patients. Stage 1 is an open Method: The study was organised into three parts. study of intrathecal buprenorphine (0.015-0.03 mg) in five paraplegic patStage 2 is a sequential designed double ients with painful muscle spasms. blind placebo controlled study of intrathecal buprenorphine (0.03 mg) in similar patients. Stage 3 is a 24 hour study of CSF kinetics following intrathecal buprenorphine (0.03 mg) in five paraplegic patients with pain but no muscle spasm. The painful muscle spasms are triggered by moving the patient and so the relief of these spasms is immediately obvious. Results: In stage 1 all five paraplegic patients obtained complete relief of painful muscle spasms for up to 48 hours following intrathecal buprenorphine. It was possible to maintain significant relief of the painful muscle The results of spasmsin all five patients with sublingual buprenorphine. stages 2 and 3 will be reported. Conclusion: The speed of onset and the completeness of the relief of the painful muscle spasm following intrathecal buprenorphine in stage 1 suggests a spinal action. The results of stages 2 and 3 may confirm or deny this presumed spinal action.

WHY TO CHLOR.

USE SUBARACHNOID IN CANCER PAIN.

MICRODOSES

OF

MORPHINE

R.M. Matossi L'Orsa, M. Delpero", Department of Anesthesiology and Pain Treatment, Nuova Astanteria Martini. Larao Gottard n"143, 10154 Torino, ITALY. The aim to reach in the treatment of Aim of Investigation: cancerpain it is maximum control of symptomatology without compromising the quality of life. This purpose it is not always easy to obtain when it is necessary to partially destroy the central or peripheric nervous system. Methods: The AA, after many years with every kind of treat-ment for pain control in advanced cancer patients, are persuaded that the results are in many cases correlative to impairment of body's functions. Results: The AA expound the results of 234 patients treated -in the last 5 years and their complications. Conclusions: The daily subarachnoid microdoses of morphine chl.' are instead very well tolerated also for long time are able to control every kind of pain and give minimum impairment.