scholarly journals Retracted: Intrathecal Pump Implantation in the Cisterna Magna for Treating Intractable Cancer Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-1
Author(s):  
Case Reports in Anesthesiology
Keyword(s):  
Cancer Pain ◽  
Cisterna Magna ◽  
Intractable Cancer Pain ◽  
Pump Implantation

scholarly journals Intrathecal Pump Implantation in the Cisterna Magna for Treating Intractable Cancer Pain

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yaling Lou ◽  
Yuefeng Rao ◽  
Zhiying Feng
Keyword(s):  
Cancer Pain ◽  
Drug Dose ◽  
Axillary Lymph ◽  
Drug Infusion ◽  
Refractory Pain ◽  
The Face ◽  
The Right ◽  
Intractable Cancer Pain ◽  
Remaining Time ◽  
Pump Implantation

A 54-year-old male patient with postoperative axillary lymph node, intrapulmonary, intracranial, and cervical spine metastases of left liver cancer was suffering from severe, persistent, and pricking pain in the right dorsal shoulder and right arm since 3 months. The drug dose of the fentanyl transdermal patch was gradually increased after admission and an adjuvant analgesic was also included, but neither treatment alleviated the pain. It was gradually alleviated after intramedullary analgesic infusion through intrathecal pump implantation in cistern magna. Terminally ill patients often have the desire to spend their remaining time at home, which however becomes a challenge in the face of refractory pain. At present, no palliative chemoradiation or ablative or stimulant neurosurgical options are available to manage pain in cancer patients. Based on the findings of this report, we concluded that an intramedullary drug infusion system can have a significant analgesic effect in patients with cervical metastasis and refractory cancer pain.

scholarly journals Complications after Intrathecal Drug Delivery Due to the Underlying Malignancy in Two Patients with Intractable Cancer Pain

2013 ◽  
Vol 2;16 (2;3) ◽  
pp. E107-E111
Author(s):  
Thomas Chai
Keyword(s):  
Drug Delivery ◽  
Side Effects ◽  
Cancer Pain ◽  
Systemic Absorption ◽  
Pain Patient ◽  
Drug Side Effects ◽  
Intrathecal Drug Delivery ◽  
Underlying Malignancy ◽  
History Of ◽  
Intractable Cancer Pain

Intrathecal drug delivery is a mode of analgesic delivery that can be considered in those experiencing both refractory pain and excessive side effects from opioid and adjuvant analgesic use. Delivery of analgesic agents directly to the cerebral spinal fluid allows binding of the drug to receptors at the spinal level. Therefore, a reduced analgesic dosage can be afforded, resulting in reduction of drug side effects due to decreased systemic absorption. Drug delivery into the intrathecal space provides this benefit, yet it does not eliminate the possibility of drug side effects or risks of complications. Complications from this route of administration may be seen in the perioperative period or beyond, including infection, inflammatory mass, bleeding, and catheter or pump dysfunction, among others. This may manifest as new/worsening pain or as a neurologic deficit, such as a sensorimotor change and bladder/bowel dysfunction. Urgent evaluation with a detailed physical examination, device interrogation, and other workup including imaging is called for if symptoms suspicious for device-related problems arise. For the cancer pain patient, the underlying malignancy should also be considered as a potential cause for these new symptoms after intrathecal system implantation. We present 2 such cases of complications in the cancer pain patient after intrathecal drug delivery due to progression of the underlying malignant process rather than to surgical or device-related problems. The first patient had a history of metastatic osteosarcoma who, shortly after undergoing an intrathecal drug delivery trial with external pump, presented with new symptoms of both pain and neurologic changes. The second patient with a history of chondrosarcoma developed new symptoms of pain and sensorimotor change several days after intrathecal drug delivery system implantation. Key words: Intrathecal analgesia, intrathecal drug delivery, perioperative complications, cancer pain, malignant pain, pain pump

scholarly journals A case of lung cancer who received intrathecal catheter implantation to relieve intractable cancer pain and opioid-induced delirium

2012 ◽  
Vol 7 (2) ◽  
pp. 585-590
Author(s):  
Toshiyuki Kuriyama ◽  
Eiko Ueyama ◽  
Yumi Nukui ◽  
Mari Nakamura ◽  
Shinobu Ishidoshiro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Pain ◽  
Intrathecal Catheter ◽  
Catheter Implantation ◽  
Intractable Cancer Pain

scholarly journals Ct-guided high level percutaneous cervical cordotomy for intractable cancer pain

2015 ◽  
Author(s):  
Ahmet Bekar ◽  
M Ozgur Taskapilioglu ◽  
Pinar Eser ◽  
Hulya Bilgin
Keyword(s):  
Cancer Pain ◽  
Ct Guided ◽  
High Level ◽  
Intractable Cancer Pain

Intraoperative Neurophysiology for Optimization of Percutaneous Spinothalamic Cordotomy for Intractable Cancer Pain

2020 ◽  
Author(s):  
Yechiam Sapir ◽  
Akiva Korn ◽  
Yifat Bitan-Talmor ◽  
Irina Vendrov ◽  
Assaf Berger ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cancer Pain ◽  
Motor Deficit ◽  
Intensity Difference ◽  
Sensory Threshold ◽  
Intractable Pain ◽  
Spinothalamic Tract ◽  
Intramedullary Spinal Cord ◽  
Stimulation Intensity ◽  
Intractable Cancer Pain

Abstract BACKGROUND Percutaneous ablation of the cervical spinothalamic tract (STT) remains a therapeutic remedy for intractable cancer pain. However, it is accompanied by the risk of collateral damage to essential spinal cord circuitry, including the corticospinal tract (CST). Recent studies describe threshold-based mapping of the CST with the objective of motor bundle preservation during intramedullary spinal cord and supratentorial surgery. OBJECTIVE To assess the possibility that application of spinal cord mapping using intraoperative neuromonitoring in percutaneous cordotomy procedures may aid in minimizing iatrogenic motor tract injury. METHODS We retrospectively reviewed the files of 11 patients who underwent percutaneous cervical cordotomy for intractable oncological pain. We performed quantitative electromyogram (EMG) recordings to stimulation of the ablation needle prior to the STT-ablative stage. We compared evoked motor and sensory electrical thresholds, and the electrical span between them as a reliable method to confirm safe electrode location inside the STT. RESULTS Quantified EMG data were collected in 11 patients suffering from intractable cancer pain. The threshold range for evoking motor activity was 0.3 to 1.2 V. Stimulation artifacts were detected from trapezius muscles even at the lowest stimulation intensity, while thenar muscles were found to be maximally sensitive and specific. The minimal stimulation intensity difference between the motor and the sensory threshold, set as “Δ-threshold,” was 0.26 V, with no new motor deficit at 3 days or 1 month postoperatively. CONCLUSION Selective STT ablation is an effective procedure for treating intractable pain. It can be aided by quantitative evoked EMG recordings, with tailored parameters and thresholds.

Transforaminal 5% Phenol Neurolysis for the Treatment of Intractable Cancer Pain

2010 ◽  
Vol 110 (1) ◽  
pp. 216-219 ◽  
Author(s):  
Kenneth D. Candido ◽  
Cyril N. Philip ◽  
Ramsis F. Ghaly ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Cancer Pain ◽  
Intractable Cancer Pain

Chronic epidural bupivacaine-opioid infusion in intractable cancer pain

Pain ◽  
1992 ◽  
Vol 49 (3) ◽  
pp. 293-300 ◽  
Author(s):  
Stuart L. Du Pen ◽  
Evan D. Kharasch ◽  
Anna Williams ◽  
Donald G. Peterson ◽  
Dean C. Sloan ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Epidural Bupivacaine ◽  
Intractable Cancer Pain

scholarly journals Disconnecting Pain: Neurosurgical Interventions for the Treatment of Intractable Cancer Pain (FR441C)

2018 ◽  
Vol 55 (2) ◽  
pp. 617
Author(s):  
Rotem Tellem ◽  
Ido Strauss ◽  
Uri Hochberg ◽  
Michal Arad Sobol
Keyword(s):  
Cancer Pain ◽  
Intractable Cancer Pain

Tailoring of neurosurgical ablative procedures in the management of refractory cancer pain

2020 ◽  
Vol 45 (9) ◽  
pp. 696-701
Author(s):  
Uri Hochberg ◽  
Asaf Berger ◽  
Miri Atias ◽  
Rotem Tellem ◽  
Ido Strauss
Keyword(s):  
Pain Relief ◽  
Cancer Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Treatment Plan ◽  
Metastatic Cancer ◽  
Spinothalamic Tract ◽  
Pain Syndromes ◽  
Intractable Cancer Pain ◽  
Ablative Procedures

IntroductionNeurosurgical ablative procedures can offer immediate and effective pain relief for patients suffering from refractory cancer pain. However, choosing the appropriate procedure for each patient may not be straightforward and warrants an interdisciplinary approach. The purpose of the current study was to evaluate the outcome of patients with cancer who were carefully selected for neurosurgical intervention by a dedicated interdisciplinary team composed of a palliative physician and nurse practitioner, a pain specialist and a neurosurgeon.MethodsA retrospective review was carried out on all patients who underwent neurosurgical ablative procedures in our institute between March 2015 and September 2019. All patients had advanced metastatic cancer with unfavorable prognosis and suffered from intractable oncological pain. Each treatment plan was devised to address the patients’ specific pain syndromes.ResultsA total of 204 patients were examined by our service during the study period. Sixty-four patients with localized pain and nineteen patients with diffuse pain syndromes were selected for neurosurgical interventions, either targeted disconnection of the spinothalamic tract or stereotactic cingulotomy. Substantial pain relief was reported by both groups immediately (cordotomy: Numerical Rating Scale (NRS) 9 ≥1, p=0.001, cingulotomy: NRS 9 ≥2, p=0.001) and maintained along the next 3-month follow-up visits.ConclusionsAn interdisciplinary collaboration designated to provide neurosurgical ablative procedures among carefully selected patients could culminate in substantial relief of intractable cancer pain.Trial registration numberIR0354-17.

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