晚期恶性肿瘤顽固性疼痛主要是神经受累或骨广泛转移所引起。一般止痛剂的效果不佳,副作用大且易成瘾。我科采用硬膜外插管注射吗啡止痛有显著的临床疗效,现报告如下。患者王某,男,56岁,于1987年5月9日因晚期肺癌伴右下腹壁及右髂骨等处转移,用杜冷丁等无法控制疼痛而入院。入院后右胸壁皮下转移性病灶作活检,病理证实为转移性粘液腺癌。住院期间病人除给以支持疗法外,采用硬膜外插管吗啡注射止痛,效果较好。吗啡硬膜外注射的操作方法注意点与不良反应:按常规硬膜外麻醉方法插管固定。硬膜外麻醉剂效应后,先给患者注射吗啡2mg,以后每12小时注射一次。吗啡必须用生理盐水稀释成0.2％浓度,慢慢推注,持续时间控制在15～20分钟。如病人感觉注射吗啡后胀痛,可加用1％普鲁卡因。每次注射吗啡时,必须严格注意无菌操作、有否泄漏、阻塞和脱落,并每周用稀碘酊与酒精消毒导管周围皮 Intractable pain in advanced malignant tumors is mainly caused by nerve involvement or extensive bone metastases. General analgesics have poor results, have large side effects and are addictive. In our department, epidural catheter injection of morphine for pain relief has a significant clinical effect. The report is as follows. Wang, male, 56 years old, was admitted to the hospital on May 9, 1987 due to advanced lung cancer with metastasis to the right lower abdominal wall and right cheekbones, and was unable to control pain with pethidine. Subcutaneous metastatic lesions of the right chest wall were used for biopsy after admission, and histologically confirmed metastatic mucinous adenocarcinoma. During the hospitalization, in addition to supportive therapy, the patient received epidural morphine injection to relieve pain and the effect was better. Morphine epidural injection method of attention and adverse reactions: according to conventional epidural anesthesia intubation. After the epidural anaesthetic effect, morphine 2 mg was given to the patient and every 12 hours later. Morphine must be diluted to 0.2% with saline and slowly infused for a duration of 15 to 20 minutes. If the patient feels pain after morphine injection, 1% procaine can be added. For each injection of morphine, strict attention must be paid to aseptic manipulation, leakage, obstruction, and shedding, and weekly disinfection of the catheter with dilute iodine and alcohol.