[Intrathecal administration of morphine and bupivacaine in the treatment of severe pain in chronic pancreatitis].
A 25-year-old male with idiopathic chronic pancreatitis suffered from severe pain not reacting to medical therapy. Intractable pain persisted after the following procedures: subtotal resection of the pancreas, interpleural administration of bupivacaine, epidural administration of bupivacaine, and thoracoscopic sympathectomy. Eventually, adequate pain relief was achieved with intrathecal administration of morphine and bupivacaine. An infusion pump, externally controlled by radiotelemetry, was implanted subcutaneously for intrathecal drug administration. With this pump the patient was fully ambulant. Intrathecal administration of morphine and bupivacaine through an implanted pump is a possible new technique for pain management in chronic pancreatitis.
Verheijen
R
R
Pijnteam/Instituut voor Anesthesiologie, Academisch Ziekenhuis, Nijmegen.
Slappendel
R
R
Jansen
J B
JB
Crul
B J
BJ
van Dongen
R T
RT
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002908:Chronic Disease; D006801:Humans; D007260:Infusion Pumps; D007278:Injections, Spinal / Q000295:instrumentation; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D010148:Intractable Pain / Q000188:drug therapy*; D010195:Pancreatitis / Q000503:physiopathology*
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine
Intrathecale toediening van morfine en bupivacïne ter behandeling van ernstige pijn bij chronische pancreatitis.