Pain reduction after low-dose morphine in two patients with abdominal pain due to carcinomatous peritonitis tolerant to fentanyl

• TAKADA Masafumi

  Department of Anesthesiology, Nagasaki University School of Medicine

• HOJO Minoru

  Department of Anesthesiology, Nagasaki University School of Medicine

• UEZONO Yasuhito

  Department of Pharmacology, Nagasaki University Graduate School of Biomedical Sciences

• SUMIKAWA Koji

  Department of Anesthesiology, Nagasaki University School of Medicine

Bibliographic Information

Other Title

• 少量のモルヒネ追加により疼痛が軽減したフェンタニル耐性のがん性腹膜炎による腹痛の2症例
• 症例 少量のモルヒネ追加により疼痛が軽減したフェンタニル耐性のがん性腹膜炎による腹痛の2症例
• ショウレイ ショウリョウ ノ モルヒネ ツイカ ニ ヨリ トウツウ ガ ケイゲンシタ フェンタニル タイセイ ノ ガンセイ フクマクエン ニ ヨル フクツウ ノ 2 ショウレイ

Abstract

The authors report two patients with abdominal pain due to carcinomatous peritonitis that did not decrease despite large doses of fentanyl but decreased after addition of low-dose morphine. Case 1 was a 15-year-old girl with abdominal pain due to ovarian cancer with peritoneal dissemination. The abdominal pain was controlled by intravenous fentanyl at a dosage of 300 μg/day for the first 3 months; thereafter, the abdominal pain worsened. Continuous intravenous fentanyl ≤ 2400 μg/day with 16 daily rescues of fentanyl 100 μg plus intravenous ketamine did not control the pain. Addition of morphine at a dosage of 50 mg/day to continuous intravenous fentanyl, however, relieved the abdominal pain. Case 2 was a 33-year-old woman with abdominal pain due to gastric cancer with peritoneal dissemination. The abdominal pain was not controlled by continuous intravenous fentanyl ≤ 9600 μg/day with 25 daily rescues of fentanyl 200 μg plus intravenous ketamine. Addition of morphine at a dosage of 150 mg/day to continuous intravenous fentanyl, however, relieved the abdominal pain. We conclude that tolerance to fentanyl may have occurred in these two patients.

Journal

• Journal of Japan Society of Pain Clinicians

  Journal of Japan Society of Pain Clinicians 15 (2), 160-164, 2008

  Japan Society of Pain Clinicians

Keywords

• cancer pain
• fentanyl
• morphine
• tolerance to opioid

Details

• CRID: 1390001204457725056
• NII Article ID: 10024130662
• NII Book ID: AN10440947
• DOI: 10.11321/jjspc.08-0004
• ISSN: 18841791
• ISSN: 13404903
• NDL BIB ID: 9525779
• Web Site: http://id.ndl.go.jp/bib/9525779
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I9525779
• Web Site: https://search.jamas.or.jp/link/ui/2008268968
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed