Abstract
We analyzed primary site of cancer, site of metastasis, physical status, causes of pain, indication and doses for morphine administration, medication, quality of daily life, and plasma morphine concentration in 136 patients who received continuous morphine drip for over ten days. The duration of morphine administration was relatively short in patients with dyspnea whereas it was relatively long in patients with pain. There was no correlation between the dose of morphine and survival time. In patients who required an increased dose of morphine a few days before their death, the most frequent complaint was dyspnea and less for abdominal distention, and the least for pain.
There was a dose-dependent increase in plasma morphine concentration in patients without pleural fluid, ascites, and edema (Y=0.89x+ 1.17, r=0.918, p<0.01). However, the plasma morphine concentration in patients with pleural fluid, ascites, and edema was about half of that observed in patients who have normal distribution area. The rapid development of pleural effusion and ascites lowered the blood level of morphine. There-fore, constant observations of the blood level of morphine should be made to see whether it has been maintained.
In the terminal care of cancer patients, at present it is most important for the physician and medical staff to take heed when the patients complain of pain.
