A successful palliative care intervention for cancer pain refractory to intrathecal analgesia.
Intrathecal delivery of opioid medications has been increasingly used to treat cancer pain that is refractory to conventional oral opioid therapy. We present a patient with complex and refractory cancer pain who failed both oral and intrathecal opioid therapy but responded to the interdisciplinary palliative care intervention in the acute palliative care unit. His morphine equivalent daily dose decreased by 94% over a 10-day period, and he had better pain control and improved function. This case highlights the importance of addressing and treating the psychosocial distress that contributes to the total pain expression.
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. asreddy@mdanderson.org
Akhila
A
Reddy
David
D
Hui
Eduardo
E
Bruera
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010148:Intractable Pain / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team
D000701:Analgesics, Opioid; D009020:Morphine