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Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review

RATIONALE: Pain is the fifth vital sign of human beings. Morphine is the first choice for relieving moderate to severe cancer pain. Most of the previous studies merely focused on the analgesic effect of high-dose or ultra-high-dose morphine in patients with advanced cancers but did not report any ca...

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Autores principales: Zhang, Xiaoling, Zhang, Jialei, Du, Yunyi, Wang, Mei, Gao, Yangjun, Zhou, Lurong, Lu, Jing, Zhao, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598791/
https://www.ncbi.nlm.nih.gov/pubmed/33126353
http://dx.doi.org/10.1097/MD.0000000000022919
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author Zhang, Xiaoling
Zhang, Jialei
Du, Yunyi
Wang, Mei
Gao, Yangjun
Zhou, Lurong
Lu, Jing
Zhao, Jun
author_facet Zhang, Xiaoling
Zhang, Jialei
Du, Yunyi
Wang, Mei
Gao, Yangjun
Zhou, Lurong
Lu, Jing
Zhao, Jun
author_sort Zhang, Xiaoling
collection PubMed
description RATIONALE: Pain is the fifth vital sign of human beings. Morphine is the first choice for relieving moderate to severe cancer pain. Most of the previous studies merely focused on the analgesic effect of high-dose or ultra-high-dose morphine in patients with advanced cancers but did not report any cases related to successful morphine withdrawal. PATIENT CONCERNS: A 42-year-old woman was admitted to our hospital in March 2019. DIAGNOSIS: She was diagnosed with progressive aggravation of headache for 1 month, which was meningeal metastasis of lung cancer. INTERVENTIONS: Symptomatic treatments like dehydration, hormone, intrathecal injection chemotherapy and an increased dose of osimertinib to 160 mg/day were applied but showed poor curative effects. The patient refused whole-brain radiotherapy. Pain intensity level was re-evaluated and the patient scored 9 based on numerical rating scale, which suggested that the patient suffered from severer cancerous pain. Thus, the patient started to receive morphine for treating headache. OUTCOMES: The patient's headache was alleviated after receiving high-dose morphine treatment, and she continued to undergo anti-cancer treatment. After tumor remission, the patient's morphine dose gradually decreased and eventually stopped, without any withdrawal symptoms. In addition, the quality of life of the patient was greatly improved with performance status scored 2 and limb muscle strength increased from Grade 2 to Grade 5. LESSONS: For patients with advanced cancers, the application of ultra-high-dose morphine may significantly relieve cancerous pain, improve survival and quality of life, and overcome their fear for death and desperation, which contributes to the establishment of a basis for subsequent anticancer treatments. Thus, timely effective pain management and routine anticancer treatments are the key to addressing the cancer pain problem.
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spelling pubmed-75987912020-11-02 Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review Zhang, Xiaoling Zhang, Jialei Du, Yunyi Wang, Mei Gao, Yangjun Zhou, Lurong Lu, Jing Zhao, Jun Medicine (Baltimore) 3300 RATIONALE: Pain is the fifth vital sign of human beings. Morphine is the first choice for relieving moderate to severe cancer pain. Most of the previous studies merely focused on the analgesic effect of high-dose or ultra-high-dose morphine in patients with advanced cancers but did not report any cases related to successful morphine withdrawal. PATIENT CONCERNS: A 42-year-old woman was admitted to our hospital in March 2019. DIAGNOSIS: She was diagnosed with progressive aggravation of headache for 1 month, which was meningeal metastasis of lung cancer. INTERVENTIONS: Symptomatic treatments like dehydration, hormone, intrathecal injection chemotherapy and an increased dose of osimertinib to 160 mg/day were applied but showed poor curative effects. The patient refused whole-brain radiotherapy. Pain intensity level was re-evaluated and the patient scored 9 based on numerical rating scale, which suggested that the patient suffered from severer cancerous pain. Thus, the patient started to receive morphine for treating headache. OUTCOMES: The patient's headache was alleviated after receiving high-dose morphine treatment, and she continued to undergo anti-cancer treatment. After tumor remission, the patient's morphine dose gradually decreased and eventually stopped, without any withdrawal symptoms. In addition, the quality of life of the patient was greatly improved with performance status scored 2 and limb muscle strength increased from Grade 2 to Grade 5. LESSONS: For patients with advanced cancers, the application of ultra-high-dose morphine may significantly relieve cancerous pain, improve survival and quality of life, and overcome their fear for death and desperation, which contributes to the establishment of a basis for subsequent anticancer treatments. Thus, timely effective pain management and routine anticancer treatments are the key to addressing the cancer pain problem. Lippincott Williams & Wilkins 2020-10-30 /pmc/articles/PMC7598791/ /pubmed/33126353 http://dx.doi.org/10.1097/MD.0000000000022919 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 3300
Zhang, Xiaoling
Zhang, Jialei
Du, Yunyi
Wang, Mei
Gao, Yangjun
Zhou, Lurong
Lu, Jing
Zhao, Jun
Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review
title Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review
title_full Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review
title_fullStr Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review
title_full_unstemmed Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review
title_short Intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: A case report and literature review
title_sort intravenous analgesia with ultra-high-dose morphine for the treatment of headache and successful withdrawal of morphine: a case report and literature review
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598791/
https://www.ncbi.nlm.nih.gov/pubmed/33126353
http://dx.doi.org/10.1097/MD.0000000000022919
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