J Korean Pain Soc.  2000 Nov;13(2):259-262.

Pain Management of Terminal Cancer Patients by Intrathecal Injection of Local Anesthetics, Opioid and Adjuvants

• Lee SH
• Kim JI
• Lee SG
• Ban JS
• Min BW

Abstract

There are many difficulties in the management of terminal cancer pain. We often encounter difficulties when nerve blocks or epidural injection of drugs do not produce good results. Local anesthetics, opioids and adjunctives, were administered to two patients intrathecally. The results were very satisfactory. It has complications such as hypotension or infection due to intrathecal route. In the first case, the pancreatic cancer patient complicated with severe epigastic pain but unfortunately no management was effective in pain control. Intrathecal injection of b upivacaine and morphine mixture was successful even if syncope which was relieved by bed rest. In the second case, the patient complicated with lower abdominal pain due to ovarian cancer who very well controlled by epidural injection of morphine and clonidine mixture but morphine demand was greatly increased. Intrathecal injection of morphine and ketamine were tried. The patient had comportable analgesic effect. CSF leakage to subcutaneous occurred but resolved by change of the catheter position or retunnelling. There were no significant complications reported in two cases.

Keyword

Anesthetics bupivacaine; morphine; Anesthetic method intrathecal; Pain cancer terminal

MeSH Terms

Abdominal Pain
Analgesics, Opioid
Anesthetics, Local*
Bed Rest
Catheters
Clonidine
Humans
Hypotension
Injections, Epidural
Injections, Spinal*
Ketamine
Morphine
Nerve Block
Ovarian Neoplasms
Pain Management*
Pancreatic Neoplasms
Syncope
Analgesics, Opioid
Anesthetics, Local
Clonidine
Ketamine
Morphine