Continuous brachial plexus neural blockade in a child with intractable cancer pain.
A 6-year-old boy presented with a large, rapidly growing osteosarcoma of the upper humerus and severe neuropathic arm pain. Despite large doses of morphine (100 micrograms/kg/hr), which resulted in intermittent somnolence and respiratory depression, his pain was poorly controlled. An interscalene brachial plexus catheter was inserted, and bupivacaine was injected on ten occasions over 5 days, with markedly improved analgesia and decreased opioid requirement. Cancer pain in children can be controlled by opioids in 95% of cases; however, circumstances such as intractable neuropathic pain may require specific regional anesthetic techniques.
Cooper
M G
MG
Department of Anesthesia, Children's Hospital, Camperdown, Sydney, Australia.
Keneally
J P
JP
Kinchington
D
D
D001859:Bone Neoplasms / Q000150:complications*; D001917:Brachial Plexus / Q000187:drug effects*; D002045:Bupivacaine / Q000627:therapeutic use*; D002648:Child; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000150:complications*; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology
D002045:Bupivacaine