Case reports: management of intractable upper extremity pain with continuous subarachnoid block at the low cervical level without impairment of upper extremity function.
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.
Fujii
Tomomi
T
Department of Anesthesiology and Resuscitology, Ehime University School of Medicine, Shitukawa, Toon City, Ehime 791-0295, Japan.
Nagaro
Takumi
T
Tsubota
Shinzo
S
Takechi
Kenichi
K
Higaki
Nobuyuki
N
Yorozuya
Toshihiro
T
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
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D008012:Lidocaine