Cervical Epidural Implant able Narcotic Delivery Systems in the Management of Upper Body Cancer Pain

Waldman, Steven D.; Feldstein, Gary S.; Allen, Mark L.; Landers, Milton H.; Turnage, Gwen

doi:10.1213/00000539-198708000-00017

Cited by 15 publications

(2 citation statements)

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“…Her left brachial plexus could neither be blocked nor even destroyed by neurolysis because of the presence of large metastatic lymph nodes: the epidural approach was therefore chosen. Although M injected by the lumbar epidural route has been shown to be effective in relieving orofacial cancer pain in adults [ 3 ] , we decided to insert a catheter directly at the cervical level in order to achieve the highest possible local morphine concentration in the CSF at the lowest dose [4]. Additionally, this approach enabled us to add a local anesthetic (B) to M. Local anesthetics have a synergistic effect at the dorsal horn level [5,6J and.…”

Section: Discussionmentioning

confidence: 99%

Cervical epidural analgesia for a cancer child at home

Veyckemans

Scholtès²,

Ninane

1994

Med. Pediatr. Oncol.

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A cervical epidural catheter was placed in a 32-month-old girl suffering from painful bone metastases of a relapsing neuroblastoma in the left forearm. This therapeutic approach was chosen because oral morphine had failed to provide analgesia while producing intolerable side effects. The epidural injection of a mixture of morphine and bupivacaine provided complete analgesia with no side effects. This enabled the parents to take care of their child at home until the end, 35 days later.

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Section: Discussionmentioning

confidence: 99%

Cervical epidural analgesia for a cancer child at home

Veyckemans

Scholtès²,

Ninane

1994

Med. Pediatr. Oncol.

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“…97 Blockade of the ganglion of Gasser, within the foramen ovale at the base of skull or its branches, may be beneficial for facial pain. 108,109 VERTEBROPLASTY Many cancer patients with metastatic vertebral compression fractures (VCFs) or osteoporotic VCFs have movementrelated back pain. Thus, the risk for deafferentation pain is significantly increased with chemical neurolysis.…”

Section: Peripheral and Cranial Nerve Blocksmentioning

confidence: 99%

Cancer Pain

Sharma¹,

Leon‐Casasola²

2014

Practical Management of Pain

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Thoracic epidural morphine in the palliation of chest wall pain secondary to relapsing polychondritis

Waldman¹,

Cronen²

1989

Journal of Pain and Symptom Management

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Relapsing polychondritis is a rare disease of unknown etiology characterized pathologically by degeneration of the chondrocyte and replacement with fibrous connective tissue. The following case report presents the pain management of a 34-yr-old man suffering from intractable pain secondary to relapsing polychondritis. Systemic narcotic analgesics, adjunctive drugs, and peripheral nerve blocks with local anesthetic and steroid failed to adequately control the patient's pain. Thoracic epidural morphine was used to provide excellent relief of pain. Factors in the selection of an implantable narcotic delivery system as well as practical considerations including tolerance and potential side effects of intraspinal narcotics are discussed. Ethical issues surrounding the chronic use of intraspinal narcotics in the setting of chronic benign pain are also discussed.

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Cervical Epidural Implant able Narcotic Delivery Systems in the Management of Upper Body Cancer Pain

Cited by 15 publications

References 0 publications

Cervical epidural analgesia for a cancer child at home

Cervical epidural analgesia for a cancer child at home

Cancer Pain

Thoracic epidural morphine in the palliation of chest wall pain secondary to relapsing polychondritis

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