Use of intrathecal morphine infusion for spasticity

Objective: To study the efficacy of intrathecal morphine infusion to treat spasticity. Setting: Functional Neurosurgery Division of University of Sao Paulo, Brazil. Method: Twelve patients with clinical refractory spasticity were studied. Two females and 10 males, with median age of 34.4 years (20 to 61 ys.). The initial Ashworth scale was 4.6. They were submitted to pump implantation for intrathecal morphine infusion. Results: The final Ashworth scale was 2.2. The median dose concentration of Intrathecal morphine was 0.95 mg, with a mean frequency of 1.8 times a day. Four patients developed pruritus, two patients nausea, two patients urinary retention, however all improved after morphine concentration was decreased. One patient was submitted to pump rewiew after extrusion catheter. Conclusions: Intrathecal morphine infusion is very helpful in patients with spasticity refractory to clinical treatment, and we observed only minor complications.