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American Society for Action on Pain

UI - 000252

AU - Hogan O

AU - Weissman DE

AU - Haddox JD

AU - Abram S

AU - Taylor ML

AU - Janjan N


AB - AB - The Medical College of Wisconsin multispecialty cancer pain service reviewed its experiences

with epidural analgesia by retrospectively reviewing hospital/clinic charts from January 1987 through

December 1989. 1205 patients (pts) were admitted to the inpatient oncology service during the study period,

and epidural analgesia was used 16 times (15 pts, 1.2%). Indications for epidural analgesia included failure

of systemic opioids and other noninvasive drug and nondrug therapies per WHO guidelines. The mean pre-

epidural equianalgesic dose of im morphine was 300 mg/day. Temporary catheters were used to assess

response to epidural morphine; if no response bupivacaine was added; if no response the catheter was

removed; if analgesia was obtained the temporary catheter was replaced by a tunneled catheter for long-term

use. Analgesia was successfully obtained in 12/16 epidural attempts; 6 with morphine alone, 6 with morphine

plus bupivacaine. 4/16 attempts were discontinued due to unacceptable toxicity or technical problems.

Tunneled catheters were used for a mean of 83 days (range 6-965 days). Catheter problems included

malfunction (7), infection (4), injection pain (4), epidural hematoma (1), hyperesthesia (1). Epidural

analgesia is infrequently indicated, bupivacaine extends the efficacy of epidural analgesia and complications

are common AD - Medical Coll. of Wisconsin AD - Milwaukee AD - WI 53211 UI - 91672498

SO - Proc Annu Meet Am Soc Clin Oncol 1991;10:A1161-A116