경막외 카테터 피하매몰법을 이용한 지속적 모르핀 투여에 의한 말기암 환자의 통증관리

• Published in: The Korean journal of pain Vol. 18; no. 1; pp. 19 - 22
• Main Authors: 류시정, Sie Jeong Ryu, 최형규, Hyung Kyu Choi, 김준영, Jun Young Kim, 김두식, Doo Sik Kim, 장태호, Tne Ho Jang, 김세환, Se Hwan Kim, 김경한, Kyung Han Kim
• Format: Journal Article
• Language: Korean
• Published: 대한통증학회 2005
• Subjects: cancer pain; epidural morphine; subcutaneous tunneling; 마취과학; cancer pain; subcutaneous tunneling; epidural morphine
• ISSN: 2005-9159; 1226-2579; 2093-0569

Background: Most terminal cancer patients suffered from intractable pain. For the treatment of these patients, opioids, via various routes, are usually administered. Continuous epidural opioid, especially morphine, administration is a good method for the management of intractable cancer pain. Methods: We retrospectively analyzed 347 terminal cancer patients, who had been treated with continuous epidural morphine infusion, between 1999 and 2004. For the epidural infusion, an epidural catheter was inserted, tunneled subcutaneously and exited from the anterior chest or abdomen. Multiday $Infursor^{(R)}$ (Baxter, 0.5 ml/h) was used for the continuous infusion. Results: Of the 347 patients studied, there were 211 males and 136 females. The mean treatment time was 54.7 days, ranging from 5 to 481 days. The mean starting and termination doses of morphine were 32.4 (for 5 days) and 100.0 mg, respectively. The doubling time of the morphine dose was 26.3 days, corresponded to a 3.8 percent increase per day. Incidental catheter removal was the most common side effect, which occurred 130 times in 61 cases. Conclusions: The procedure of epidural catheterization, with subcutaneous tunneling, was simple and inexpensive. Despite the disadvantages, such as incidental catheter removal, it is a useful method for the control of terminal cancer pain.