title: Management of postoperative pain after T6 corpectomy: use of epidural bupivacaine and sufentanil--a case report.
abstract: The objective of this case report is to discuss the successful postoperative analgesic management in a patient who had disseminated rectal cancer pain and failed to obtain pain relief despite high-dose intravenous hydromorphone. A 45-year-old male had metastatic rectal cancer involving multiple vertebrae. After a T6 corpectomy, the patient failed to obtain effective pain relief with massive doses of parenteral opioids. The epidural catheter was placed under fluoroscopy. The patient subsequently failed to obtain relief with epidural administration of bupivacaine and hydromophone. Epidural sufentanil was used to obtain adequate pain control. Postoperative epidural analgesia is a technique worthy of consideration for patients with extreme opioid dependency for corpectomy. Epidural sufentanil can successfully be administered for postoperative pain control for patients receiving a large dose of opioids for cancer pain.
authors.affiliation: Cedars-Sinai Institute for Spinal Disorders, Los Angeles, Calif., USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Huang
authors.forename: Carl
authors.initials: C
authors.lastname: Lauryssen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D015360:Analgesia, Epidural; D000777:Anesthetics / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010149:Postoperative Pain / Q000188:drug therapy*; D012004:Rectal Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D017409:Sufentanil / Q000008:administration & dosage*; D013904:Thoracic Vertebrae / Q000601:surgery
chemical_list: D000777:Anesthetics; D017409:Sufentanil; D002045:Bupivacaine