title: Case reports: management of intractable upper extremity pain with continuous subarachnoid block at the low cervical level without impairment of upper extremity function.
abstract: We present a case of continuous subarachnoid block for the treatment of refractory cancer pain in the shoulder and upper extremity on the right side of the patient. The catheter tip was placed in the subarachnoid space close to the nerve roots on the right side at the height of C5 corresponding to the painful region. Until the patient died, his pain was controlled with infusions of bupivacaine (30-58.7 mg/d) and morphine (2-19.6 mg/d) for 120 days during which upper extremity function was not disturbed and respiratory function and performance status were improved. This case suggests continuous subarachnoid block at the low cervical level is useful for refractory cancer pain in the shoulder and upper extremity.
authors.affiliation: Department of Anesthesiology and Resuscitology, Ehime University School of Medicine, Shitukawa, Toon City, Ehime 791-0295, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Fujii
authors.forename: Takumi
authors.initials: T
authors.lastname: Nagaro
authors.forename: Shinzo
authors.initials: S
authors.lastname: Tsubota
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takechi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Higaki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Yorozuya
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local; D002574:Cervical Vertebrae; D017809:Fatal Outcome; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications; D009407:Nerve Block; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement / Q000187:drug effects; D020069:Shoulder Pain / Q000628:therapy*; D013346:Subarachnoid Space; D034941:Upper Extremity / Q000502:physiology*; D016138:Walking
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D008012:Lidocaine