Intraspinal opiates for treatment of intractable pain in the terminally ill cancer patient

Robert P. Iacono, Jennifer Linford, Reuven Sandyk, Paul Consroe, Margaret R. Ryan, Colin R. Bamford

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Abstract

The discovery of opiate receptors and then their endogenous ligands in 1974 (Snyder et al., 1974) has elucidated a vast pharmacology of opiates providing a basis for their diverse clinical applications. With the awareness of quality of life as a primary goal in terminal cancer patients, widespread attention has been drawn to the direct delivery of long-term intraspinal analgesics to cancer patients for who all medical pain control regimens have failed (Coombs & Saunders, 1974). Intraspinal administration of opiates and nonopiate analgesics is not only appealing on theoretical grounds but provides a minimally invasive method to insure otherwise unobtainable pain relief while eliminating obtundation and systemic side-effects associated with conventional therapy (Cobb et al., 1984; Harbaugh et al., 1982; Leavens et al., 1982; Malone et al., 1985; Onofrie et al., 1981; Poletti et al., 1981). Although intraspinal opiates have been used in the treatment of postoperative and benign-pain syndromes (Asari et al., 1981; Cousins & Mather, 1984), in our discussion we review the basic science, current techniques and possible future improvements in spinal analgesia in the control of chronic cancer pain.

Original languageEnglish (US)
Pages (from-to)111-119
Number of pages9
JournalInternational Journal of Neuroscience
Volume38
Issue number1-2
DOIs
StatePublished - Jan 1 1988

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Keywords

  • Cancer patient
  • Morphine
  • Opiate receptors
  • Opiates
  • Pain
  • Spinal cord

ASJC Scopus subject areas

  • Neuroscience(all)

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