Cervical epidural analgesia for a cancer child at home

Veyckemans, Francis; Scholtès, Jean-Louis; Ninane, J.

doi:10.1002/mpo.2950220111

Cited by 8 publications

(1 citation statement)

References 10 publications

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“…[ 15 ] Cervical epidural analgesia is described in literature on cancer pain. [ 16 17 ] Techniques commonly used in continuous blockade of neural structures, such as subcutaneous tunneling and catheter fixation, use of bacterial filters, and general care of continuous catheters are recommended in such cases with advanced cancer. [ 16 18 ] A recent review of literature that examined cervical epidural analgesia in overall practice remained equivocal on its role while highlighting the need for careful selection of cases for this intervention.…”

Section: Discussionmentioning

confidence: 99%

Continuous cervical epidural analgesia in metastatic spinal cord compression

Menon¹,

Taha²,

Purohit³

et al. 2016

Indian J Palliat Care

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Metastatic spinal cord compression is a devastating complication of cancer. Patients may often require high doses of opioids that may cause side effects, myoclonus being one such. A 63-year-old male suffering from malignant spinal cord compression was admitted to our institution. The primary team managed him conservatively with pharmacotherapy with no relief of pain, and he experienced myoclonus and sedation as adverse effects. A continuous cervical epidural catheter with local anesthetic infusion was inserted for 5 days to control his pain. This relieved his pain, which was sustained even after we removed the epidural catheter on day 5, for up to 64 days until the time of his death. Continuous cervical epidural local anesthetic infusions may help with refractory pain by deafferentation of noxious stimuli. Central neuraxial blocks may be a valuable rescue in selected patients.

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Section: Discussionmentioning

confidence: 99%

Continuous cervical epidural analgesia in metastatic spinal cord compression

Menon¹,

Taha²,

Purohit³

et al. 2016

Indian J Palliat Care

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Reduction of nausea and vomiting from epidural opioids by adding droperidol to the infusate in home-bound patients

Aldrete¹

1995

Journal of Pain and Symptom Management

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In 184 adult patients with severe nonmalignant low back pain from postlaminectomy syndrome, temporary lumbar epidural catheters were infused with either 0.25% bupivacaine 92 mL, fentanyl 600 micrograms, and droperidol 5 mg (Group A), or 0.25% bupivacaine 92 mL, fentanyl 600 micrograms, and NaCl 0.9% 2 mL (Group B). Infusion rates ranged from 0.5 to 2 mL per hour, with an option for turning the infusion off when the patient had no pain and turning it on when the pain returned. Infusions were continued from 2 to 55 days, during which time the patient was at home. In Group A, only two patients had nausea without emesis, while in Group B, nausea occurred in 18 patients (P < 0.04) and four vomited (P < 0.05). The number of patients with headache, pruritus, somnolence, and/or numbness was minimal and without statistically significant group differences. During treatments, pain levels were 2 or less on a 10-cm visual analogue scale. Added to the epidural infusate, droperidol appears to significantly reduce nausea and vomiting in ambulatory patients receiving fentanyl and bupivacaine in extended epidural infusions. The possibility that droperidol potentiates analgesic effects could not be evaluated.

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