Neurological Associates

Pain Management Center

Vero Beach, Florida

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RSD PUZZLE #29
"THEY TRIED THE MORPHINE PUMP ON ME AND IT MADE ME VERY SICK,
I WAS ALLERGIC TO IT"


It is not at all uncommon for the patient to be tried on infusion pump while she is not properly tapered off other narcotics. As a result, the combination makes the patient quite sick.

In some patients the patient is intolerant of even a very small dosage of Morphine or Dilaulid in the spinal fluid. I such patients an addition of a very small amount of Clonidine in the pump (small doses of 75-125 microgram) help enhance the pain control. As a result, the dosage of the Morphine or Dilaulid can be reduced to quite a small amount and yet effective relief of pain can be achieved without nausea.

In addition, the infusion pump should not be tried unless the patient is already detoxified for at least 1 week from other forms of narcotics.

The infusion pump usually requires small enough dosage of Morphine or Dilaulid so that there would be no suppression of secretion of cerebral endorphines. This is usually between 2 to 8 (up to 9) milligram per kilogram Morphine. On the other hand if one goes above the 9mg dosage, the pain recurs due to the suppression of the endorphine function. This is a frequent cause of failure of infusion pumps.

In our series of over 80 patients with infusion pumps, there has been 82% success in patients who have otherwise been totally 100% failure in control of their pain. The 18% failure has been due to either intolerance to the medication, or infection. Infection alone is not a contraindication because the pump can be removed and replaced later on. In two patients among the failure group, the body rejected the foreign body of the pump by either forming a lot of scar and granulation at the tip of the catheter or around the pump itself. This is a rare complication.


H. Hooshmand, M.D.

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Copyright © 1997-2006 H. Hooshmand, M.D. No part of this publication may be reproduced, transmitted, stored in a retrieval system other than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.

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The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.

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This page was last updated on 3/11/2000.