J Korean Pain Soc.
1999 May;12(1):95-100.
Terminal Cancer Pain Management by Tunnelled Epidural Catheter
- Affiliations
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- 1Department of Anesthesiology, College of Medicine, Kosin University, Korea.
- 2Department of Anesthesiology, Segang Hospital, Pusan, Korea.
Abstract
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BACKGROUND: About 75% of terminal cancer patients have severe pain. For the treatment of these
patients, physicians usually use potent opioid analgesics. But many of the cancer patients were
not controlled by IV or IM injection of opioids. In spite of the untreatable nature of the
patient's illness, they should be hospitalized only for pain control. In that case, epidural
opioid injection is one of the most effective methods in pain management.
METHODS
We retrospectively analyzed 126 terminal cancer patients who were treated with epidural
morphine for pain management from 1993-97. In the routine procedure, an epidural catheter was
inserted into the epidural space and tunnelled subcutaneously, exiting out from the anterior
chest or abdomen. Morphine was used as the main analgesic and Multiday Infusor(R) (Baxter, 0.5 ml/h)
as a continuous infusion system,
RESULTS
1. Mean treatment time was 55 days (range; 3-373). 2. Mean daily epidural start mg dose
of morphine was 8 mg (range; 2-20). 3. Mean daily dose at termination was 19 mg (range; 4-60)
4. 94 patients were controlled with continuous infusion but 32 patients needed additional bolus
doses of morphine. 5. Atheter-associated subcutaneous infection occurred in 2 patients (1.6%).
CONCLUSION
Terminal cancer pain management administered by a tunnelled epidural catheter is a
simple, inexpensive method with a very small rate of infection.