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Epidural Analgesia Using High Dose Morphine in a Terminal Lung Cancer Patient -A case report-  

Lee, Ji Yeon (Departments of Anesthesiology and Pain Medicine, Inha University College of Medicine)
Shinn, Helen Ki (Departments of Anesthesiology and Pain Medicine, Inha University College of Medicine)
Kim, Tae Jung (Departments of Anesthesiology and Pain Medicine, Inha University College of Medicine)
Cho, Young Deog (Departments of Anesthesiology and Pain Medicine, Inha University College of Medicine)
Song, Ha Na (Departments of Anesthesiology and Pain Medicine, Inha University College of Medicine)
Yang, Chun Woo (Konyang University College of Medicine)
Publication Information
The Korean Journal of Pain / v.19, no.1, 2006 , pp. 96-100 More about this Journal
Abstract
Pain control is very important in managing terminal cancer patients and there are several modalities to alleviate their pain. A high dosage of epidural morphine is effective to control terminal cancer pain. Furthermore, to decrease the amount of morphine, adding an alternative adjuvant like ketamine to the morphine regimen is considered helpful for controlling the pain of a terminal cancer patient. A 45 year old male patient with terminal lung cancer had neck pain that was caused by multiple bone metastases. Continuous epidural block was started with 2 mg/day of morphine and the dosage was gradually increased to 90 mg/day in 86 days. 30 mg/day of ketamine was then added to it. Overall, the morphine and ketamine dosages were increased to 564 mg/day and 140 mg/day, respectively, in 11 months until the patient expired. In this case, the high dosage of epidural morphine, 580 mg/day, was administered to control cancer pain without any severe adverse effects.
Keywords
cancer; epidural morphine; ketamine;
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