COMPARATIVE STUDY BETWEEN REPEATED INTRATHECAL INJECTION OF CALCITONIN AND MORPHINE FOR MANAGEMENT OF CANCER PAIN

Abstract

Intrathecal delivery is an effective way to distribute drugs for spinal or cerebral conditions, such as chronic pain. Infusion pumps can be used to deliver agents continuously into the subarachnoid space. Intrathecal infusion is currently used clinically to deliver analgesics for chronic pain. In spite of initial dreams, spinal opioids have failed to solve the main problem to have only a good analgesic effect without side effects such as respiratory depression, nausea, vomiting, itching and urinary retention.

The search for newer agents to act as substitutes for spinal opioids without their side effects have been started. In this work we studied the antinociceptive effect of calcitonin in chronic cancer pain. This study was conducted on 40 patients complaining of neuropathic pain affecting their lower abdomen or lower extremities. The patients were randomly allocated into 2 groups to receive repeated doses of either 20IU calcitonin or 0.2 mg morphine in 2ml. Blood samples were analyzed for calcium & parathyroid hormone. Haemodynamic monitoring for pulse rate, blood pressure, and respiratory rate were obtained just before intrathecal administration and then 3 Omintes, 1 hour and then every 6 hours.after injection.

Pain score using the VAS was assessed. In the calcitonin group adequate analgesia was achieved and was faster in onset and more potent than that of morphine. Nausea and vomiting were the most noticeable side effects in the two groups.

Key words:

(Calcitonin. Intrathecal Calcitonin- Chronic Cancer Pain . Intrathecal

Analgesia. Calcitonin & Chronic Cancer Pain)