title: Two cases of thoracic epidural neurolysis after local anesthetic titration in cancer patients.
abstract: Two patients who underwent thoracic epidural neurolysis after titration using local anesthetic are reported. Case 1 suffered serious back and epigastric pain arising from metastasis of lung cancer and Case 2 was not relieved right chest pain by costal metastasis from urethral cancer only by morphine. Block therapies improve the patients' quality of life if these underwent in opioid resistant pain or moving pain. Among them subarachnoid neurolytic blockage or epidural continuous blockage are usually selected in terminal stage. Subarachnoid blockage is potent but usually induces paresthesia and hypesthesia and patient has to keep lateral position under affected site intraoperatively. Epidural block is easy to treat but is difficult to continue because of infection and decrement of efficacy attributed adhesion of epidural space, stress arose from immobilization. We operate epidural neurolytic blockage for these patients and they were relieves from pain without suffer from the side effect.
authors.affiliation: Department of Anesthesiology, Fukushima Medical University School of Medicine, Fukushima, Japan. kaoru-t@fmu.ac.jp
authors.forename: Kaoru
authors.initials: K
authors.lastname: Takahashi-Sato
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Midori
authors.initials: M
authors.lastname: Mogami
authors.forename: Mariko
authors.initials: M
authors.lastname: Muto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murakawa
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D004824:Epidural Space; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology*; D009407:Nerve Block / Q000379:methods*; D010148:Intractable Pain / Q000188:drug therapy*
chemical_list: D000779:Anesthetics, Local