[Intrathecal segmental analgesia with a single dose of bupivacaine for cancer pain in the abdominal wall].
A 48-year-old woman, diagnosed as colon cancer with metastases in the liver, lung, bone and left rectus abdominis, developed refractory left abdominal pain in spite of escalating administration of opioids and nerve block therapy, and intrathecal analgesia was applied. The tip of the catheter was intrathecally placed at the level of the T8 vertebra and pain relief was obtained with a daily dose of bupivacaine 36 mg producing segmental analgesia of the area between the 7th and 10th thoracic segments and preserving sensory and motor functions of the lower limbs. Face scale scores decreased from 5/6 to almost 0 after induction of the intrathecal analgesia. Side effects related to systemic opioids, such as nausea, vomiting and sleepiness, significantly improved and she was able to walk to the toilet. It is suggested that when the site of pain is limited to the truncus, intrathecal analgesia only with local anesthetics can be applied without affecting functions of the lower limbs.
Kurihara
Yuka
Y
Department of Anesthesia, The Hyogo Medical Center for Adults, Hyogo, Japan.
Ikegaki
Junichi
J
Kato
Hiromi
H
Chigusa
Suzuko
S
Kaetsu
Hiroshi
H
D000008:Abdominal Neoplasms / Q000150:complications* / Q000556:secondary*; D015746:Abdominal Pain / Q000209:etiology* / Q000628:therapy*; D034861:Abdominal Wall; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D003110:Colonic Neoplasms / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology* / Q000628:therapy*
D002045:Bupivacaine