Video-assisted thoracoscopic neurectomy of intercostal nerves in a patient with intractable cancer pain.
Cancer-related pain is complicated and unbearable. Pain management techniques must be constantly modified and improved, with the goal of decreasing pain and enabling patients to withstand it. A 56-year-old man with colon cancer and multiple metastases was suffering from intense pain that was not relieved by extremely high doses of intravenous morphine. Temporary pain relief was achieved twice by blockade of the intercostal nerves with local anesthetics. Radiofrequency ablation was then performed under fluoroscopic monitoring; however, the procedure resulted in little pain relief. Finally, a neurectomy to cauterize the intercostal nerves was completed with video-assisted thoracoscopy under general anesthesia.
Lai
Yu-Yung
YY
Department of Anesthesiology, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan, Republic of China. YuhYeong_Lai@tzuchi.com.tw
Chen
Shi-Chi
SC
Chien
Nai-Chuan
NC
D003110:Colonic Neoplasms / Q000150:complications; D006801:Humans; D007367:Intercostal Nerves / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement / Q000379:methods; D010148:Intractable Pain / Q000209:etiology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome