INTRATHECAL MORPHINE - NEW METHOD OF OBSTETRIC ANALGESIA

The imaginative and provocative study by Yaksh and his colleagues, reported in this issue of the Journal, prompts some editorial musings and, not surprisingly, raises as many questions, if not more, than are answered or even answerable. The theoretical basis for the use of intrathecal morphine is briefly but carefully discussed by Yaksh and his associates, and is not further elaborated here. However, it is interesting that of the 26 references cited, 22 are dated 1975 or later. This admittedly crude index suggests the pace at which our concepts of pain mechanisms and control are changing. The putative advantages of pain relief by intrathecal morphine are great. Preliminary findings in man with intractable pain of inoperable cancer, although limited in scope, are encouraging, but support the notion that evaluation will not be simple. It is ironic but perhaps fitting that the earliest studies of this potentially revolutionary concept should be directed at both the beginning and the end of life.