The conversion challenge: From intrathecal to oral morphine

American Journal of Hospice and Palliative Medicine

Volumn 21, Issue 2, 2004, Pages 143-147

  Sylvester, Robert K ^a,b   Lindsay, Stephanie M ^a   Schauer, Caroline ^c  

^a MeritCare Hospital   (United States)

^b NORTH DAKOTA STATE UNIVERSITY   (United States)

^c Hospice of the Red River Valley   (United States)

Author keywords

Dosage conversion; Equianalgesic conversion; Equianalgesic doses; Intraspinal morphine; Intrathecal morphine

Indexed keywords

AMITRIPTYLINE; ATENOLOL; BACLOFEN; BISACODYL; BUPIVACAINE; CLONIDINE; FUROSEMIDE; GABAPENTIN; MORPHINE; MORPHINE SULFATE; SERTRALINE; TIZANIDINE; TOLTERODINE; NARCOTIC ANALGESIC AGENT;

ADULT; ANAMNESIS; CASE REPORT; CHRONIC PAIN; CLINICAL FEATURE; FEMALE; HUMAN; LABORATORY TEST; REVIEW; SPINAL PAIN; SUSTAINED DRUG RELEASE; TABLET; INFUSION PUMP; INTRASPINAL DRUG ADMINISTRATION; MIDDLE AGED; MULTIPLE SCLEROSIS; ORAL DRUG ADMINISTRATION; PHARMACOKINETICS;

ADMINISTRATION, ORAL; ANALGESICS, OPIOID; FEMALE; HUMANS; INFUSION PUMPS, IMPLANTABLE; INJECTIONS, SPINAL; MIDDLE AGED; MORPHINE; MULTIPLE SCLEROSIS; THERAPEUTIC EQUIVALENCY;

EID: 2342433958     PISSN: 10499091     EISSN: None     Source Type: Journal    
DOI: 10.1177/104990910402100214     Document Type: Review

References (27)

1. Wang JK: Analgesic effect of intrathecally administered morphine. Reg Anesth. 1977; 60: 3-8.
2. Onofrio BM, Yaksh TL, Arnold PG: Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. Mayo Clin Proc. 1981; 56: 516-520.
3. Brazenor GA: Long term intrathecal administration of morphine: A comparison of bolus injection via reservoir with continuous infusion by implanted pump. Neurosurgery. 1987; 21: 484-491.
4. Yaksh TL, Onofrio BM: Retrospective consideration of the doses of morphine given intrathecally by chronic infusion in 163 patients by 19 physicians. Pain. 1987; 31: 221-223.
5. Hogan Q, Haddox JD, Abram S, et al.: Epidural opiates and local anesthetics for the management of cancer pain. Pain. 1991; 46: 271-279.
6. Zech DFJ, Grond S, Lynch J, et al.: Validation of World Health Organization guidelines for cancer pain relief: A 10-year prospective study. Pain. 1995; 63: 65-76.
7. Gourlay GK, Plummer JL, Cherry DA, et al.: Comparison of intermittent bolus with continuous infusion of epidural morphine in the treatment of severe cancer pain. Pain. 1991; 47: 135-140.
8. Du Pen SL, Williams AR: The dilemma of conversion from systemic to epidural morphine: A proposed conversion tool for treatment of cancer pain. Pain. 1994; 56: 113-118.
9. Hassenbusch SJ, Stanton-Hicks M, Covington EC, et al.: Long-term intraspinal infusion of opioids in the treatment of neuropathic pain. J Pain Symptom Manage. 1995; 10: 527-543.
10. Krames ES: Intraspinal opioid therapy for chronic nonmalignant pain: Current practice and clinical guidelines. J Pain Symptom Manage. 1996; 11(6): 333-352.
11. Winkelmuller M, Winkelmuller W: Long-term effects of continuous intrathecal opioid treatment in chronic pain of nonmalignant etiology. J Neurosurg. 1996; 85: 458-467.
12. Paice JA, Penn RD, Shott S: Intraspinal morphine for chronic pain: A retrospective, multicenter study. J Pain Symptom Manage. 1996; 11: 71-80.
13. Anderson VC, Burchiel KJ: A prospective study of long-term intrathecal morphine in the management of chronic nonmalignant pain. Neurosurgery. 1999; 44: 289-300.
14. Mercadante S: Problems of long-term spinal opioid treatment in advanced cancer patients. Pain. 1999; 79: 1-13.
15. Roberts LJ, Finch PM, Goucke CR, et al.: Outcome of intrathecal opioids in chronic non-cancer pain. Eur J Pain. 2001; 5: 353-361.
16. Rainov NG, Heidecke V, Burkert W: Long-term intrathecal infusion of drug combinations for chronic back and leg pain. J Pain Symptom Manage. 2001; 22: 862-871.
17. Gatscher S, Becker R, Uhle E, et al.: Combined intrathecal baclofen and morphine infusion for the treatment of spasticity related pain and central deafferentiation pain. Acta Neurochir Suppl. 2002; 79: 75-76.
18. Donnelly S, Davis MP, Walsh D, et al.: Morphine in cancer pain management: A practical guide. Support Care Cancer. 2002; 10: 13-35.
19. Bennett G, Burchiel K, Buschser E, et al. Clinical guidelines for intraspinal infusion: Report of an expert panel. J Pain Symptom Manage. 2000: 20(2); S37-S43.
20. Gebhardt R, Kinney MAO: Conversion from intrathecal morphine to oral methadone. Reg Anesth Pain Med. 2002; 27: 319-321.
21. Cynergy Group Opioid Calculator Web site. Available at www.cynergygroup.com/ Demo/cgi-bin/calc/disclaimer.asp.
22. Samuelsson H, Malmberg F, Eriksson M, et al.: Outcomes of epidural morphine treatment in cancer pain: Nine years of clinical experience. J Pain Symptom Manage. 1995; 10: 105-112.
23. Kalso E, Heiskanen T, Rantio M, et al.: Epidural and subcutaneous morphine in the management of cancer pain: A double blinded cross-over study. Pain. 1996; 67: 443-449.
24. Package insert. Duramorph (preservative-free morphine sulfate sterile solution). Cherry Hill, NJ: Elkins-Sinn Inc., 1994.
25. Sarvela J, Halonen P, Soikkeli A, et al.: A double-blinded, randomized comparison of intrathecal and epidural morphine for elective cesarean delivery. Anesth Analg. 2002; 95: 436-440.
26. Hardman JG, Limbird LL, Gilman AG (eds.) The Pharmacological Basis of Therapeutics (10th Edition). New York: McGraw-Hill, 2001; pp. 581,589.
27. Osborne R, Simon J, Duncan T, et al.: Morphine and metabolite behavior after different routes of morphine administration: Demonstration of the importance of the active metabolite morphine-6-glucuronide. Clin Pharmacol Ther. 1990; 47: 12-19.