Korean J Anesthesiol.  2008 Jul;55(1):135-138. 10.4097/kjae.2008.55.1.135.

Upper body cancer pain management by cervical intrathecal catheterization: A case report

• Hong SH
• Lee GW

• KMID: 1782536
• DOI: http://doi.org/10.4097/kjae.2008.55.1.135

Abstract

It has been known that more than 5% of cancer patients experience severe pain refractory to medical treatments. So it is necessary to use epidural or intrathecal analgesia with opioids and local anesthetics when systemic trial has failed. Although intrathecal catheter placement and drug infusion has some risks, it shows better pain control with least amount of analgesics. The authors managed a patient who had suffered from intractable cancer pain due to metastatic pancreatic cancer. His pain was spreading to his upper body area including chest wall and interscapular region as well as original abdomen and back pain. Pain severity became extreme reaching VAS (visual analogue scale) score to above 9. Cervical epidural catheterization and continuous drug infusion was not effective in this case. So the authors chose to give analgesics intrathecally, and placed the intrathecal catheter on 5th cervical vertebral level and connected it to subcutaneous port so that drugs could be infused continuously. The effect was dramatic by 5 mg/day morphine and 20 mg/day lidocaine, VAS score decreased to below 3 without any possible complications.

Keyword

cancer pain; cervical; intrathecal catheter

MeSH Terms

Abdomen
Analgesia
Analgesics
Analgesics, Opioid
Anesthetics, Local
Back Pain
Catheterization
Catheters
Humans
Lidocaine
Morphine
Pain Management
Pancreatic Neoplasms
Thoracic Wall
Analgesics
Analgesics, Opioid
Anesthetics, Local
Lidocaine
Morphine