Pain Scores and Ventilatory and Circulatory Sequelae of Epidural Morphine in Cancer Patients with and without Prior Narcotic Therapy

Cross-tolerance to epidural morphine after prior systemic morphine therapy was studied in 26 cancer patients treated for relief of pain secondary to metastatic disease. A 'tolerance index' was calculated for each patient by multiplying the duration of previous morphine therapy with the daily dose just prior to the study and then compared with changes in the following variables measured after epidural morphine administration: with pain scores on a scale from 0 (no pain) to 10 (maximal pain), heart rate, blood pressure, respiratory rate and minute volume, arterial blood gas tensions of oxygen and carbon dioxide and arterial pH. There was no significant analgesic cross-tolerance to epidural morphine, but clear evidence for cross-tolerance regarding morphine's respiratory depressant action. The duration of the previous morphine therapy exerted a greater influence on the development of ventilatory cross-tolerance than the dose.

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Pain Scores and Ventilatory and Circulatory Sequelae of Epidural Morphine in Cancer Patients with and without Prior Narcotic Therapy

Cited by 10 publications

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Antinociceptive effect of intrathecal morphine in tolerant and nontolerant spinal rats

Antinociceptive effect of intrathecal morphine in tolerant and nontolerant spinal rats

Tolerance to the antinociceptive effect of intrathecal morphine in intact and chronic spinal rats

Cross-tolerance between systemic and epidural morphine in cancer patients

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