모르핀, 국마제 및 항우울제의 경막외강내 지속혼주의 효과

Effects of the Mixture of Morphine, Bupivacaine and Antidepressants by Continuous Epidural Infusion in Cancer and Non-cancer Pain

This study was objected to evaluate clinical progressions about both the degree of pain relief and the occurrence of morphine tolerance while the epidural analgesia with low dose of morphine, bupivacaine and antidepressant continued repeatedly at every 5 day intervals of the constant-rate infusion(0.5 ml/hr, 60 ml capacity). The subjects were divided to 56 cancer and 36 non-cancer patients who failed to respond to palliative treatments. Before the relief of pain, the pain severity was moderate(10%) and severe(90%). The dose escalation of morphine noted to 11(20%)patients in cancer pain and to one(5%) case only in non-cancer. During the epidural analgesia, the effect of pain relief was moderate(11%) and good(89%). It suggest that the morphine tolerance may be reduced to some degree such as an initial minimum dose of epidural morphine with local anesthetic and antidepressant should be adjusted on an individual basis using the constant-rate infusor, even though rapid dose escalation occurrs in some patients who the diseases progress over a short period of time.