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 Efficacy and Safety of Ropivacaine Addition to Intrathecal Morphine for Pain Management in Intractable Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ying Huang ◽  
Xihan Li ◽  
Tong Zhu ◽  
Jian Lin ◽  
Gaojian Tao
Keyword(s):  
Pain Relief ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Barthel Index ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intrathecal Morphine ◽  
Drug Infusion ◽  
Intrathecal Catheter ◽  
Intractable Cancer Pain

Objective. Although intrathecal drug infusion has been commonly adopted for terminal cancer pain relief, its adverse effects have made many clinicians reluctant to employ it for intractable cancer pain. The objective of this study is to compare the efficacy and security of an intrathecal continuous infusion of morphine and ropivacaine versus intrathecal morphine alone for cancer pain.Methods. Thirty-six cancer patients received either a continuous morphine (n=19) or morphine and ropivacaine (n=17) infusion using an intrathecal catheter through a subcutaneous port. Numerical Rating Scale (NRS) scores and the Barthel Index were analyzed. Adverse effects and complications on postoperative days 1, 3, 7, and 15 were also analyzed.Results. All patients experienced pain relief. Compared to those who received morphine alone, patients receiving morphine and ropivacaine had significantly lower postoperative morphine requirements and higher Barthel Index scores on the 15th postsurgical day (P<0.05). Patients receiving morphine and ropivacaine had lower NRS scores than patients receiving morphine alone on postoperative days 1, 3, 7, and 15 (P<0.05). Negative postsurgical effects were similar in both groups.Conclusions. Morphine and ropivacaine administration through intrathecal access ports is efficacious and safe and significantly improves quality of life.

Retrograde placement of an intrathecal catheter for chronic low pelvic cancer pain

2019 ◽  
Vol 54 ◽  
pp. 43-44
Author(s):  
Ivan Urits ◽  
Julie Petro ◽  
Omar Viswanath ◽  
Musa Aner
Keyword(s):  
Cancer Pain ◽  
Intrathecal Catheter ◽  
Pelvic Cancer

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 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

Subdural Blood Patch for the Treatment of Persistent CSF Leak After Permanent Intrathecal Catheter Implantation: A Report of Two Cases

Pain Practice ◽  
2001 ◽  
Vol 1 (4) ◽  
pp. 344-353 ◽  
Author(s):  
Eric Dominguez ◽  
Osman Latif ◽  
Dima Rozen ◽  
Bolkar Sahinler ◽  
Mauricio Orbegozo ◽  
...  
Keyword(s):  
Csf Leak ◽  
Intrathecal Catheter ◽  
Blood Patch ◽  
Catheter Implantation

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
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