title: Continuous intrathecal meperidine for severe refractory cancer pain: a case report.
abstract: The control of severe cancer pain may be problematic despite advances in pain management. Patients with severe intractable pain and/or intractable side effects may require aggressive interventional pain management strategies including the administration of medications by the continuous intrathecal route and/or neurosurgical procedures. Various medications, including opioids, local anesthetics, and alpha-2 agonists may be used intrathecally for the control of cancer pain. Failure of the intrathecal route may require the additional use of neurosurgical procedures such as cordotomy for pain control. We describe a case of severe cancer pain refractory to conventional intrathecal medications and cordotomy that was successfully managed by the addition of meperidine to the intrathecal regimen.
authors.affiliation: Pain Service and Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA 98195, USA. kjsouter@u.washington.edu
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Souter
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Davies
authors.forename: John D
authors.initials: JD
authors.lastname: Loeser
authors.forename: Dermot R
authors.initials: DR
authors.lastname: Fitzgibbon
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002818:Cordotomy; D006801:Humans; D007278:Injections, Spinal / Q000379:methods*; D008297:Male; D008614:Meperidine; D012516:Osteosarcoma / Q000150:complications*; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology* / Q000601:surgery; D010166:Palliative Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D008614:Meperidine