Intrathecal Catheter and Subcutaneous Access Port Implantation in Pain Management for Terminal Cancer Patient - A case report -

Abstract

It is important to treat cancer-related pain in cancer patients to ensure the life quality of the patient, as well as to improve their life span. It has been estimated that at least 5% of cancer patients have pain refractory to medical treatment. Therefore, the need for epidural or intrathecal analgesia with opioids and local anesthetics is indicated if systemic treatment has failed. Intrathecal catheter placement and implantation of the injection port for administration of opioids and local anesthetics may improve pain relief in patients who are unresponsive to epidural routes. Although intrathecal implantation has several complications, similar infection rates have been reported between intrathecal and epidural administration. In addition, intrathecal administration showed better outcomes, including improved pain control, lowered daily doses, and an improvement in the level of drowsiness experienced when compared to epidural administration. We report here a case in which a terminal cancer patient was treated using an intrathecal catheter and subcutaneous port. The patient had cancer-related pain that could not be controlled by epidural opioid administration. Based on the results presented here, we suggest that intrathecal implantation is a feasible long term pain management method for intractable cancer pain patients. (

Continuous Intrathecal Morphine Administration for Cancer Pain Management Using an Intrathecal Catheter Connected to a Subcutaneous Injection Port: A Retrospective Analysis of 22 Terminal Cancer Patients in Korean Population

“…A much wider application of intrathecal therapy for patients with cancer pain has been advocated recently [4]. However, there are only a few case reports regarding the use of intrathecal opioids in cancer pain in the literature published in Korea [5,6]. Therefore, we performed a retrospective analysis, examining pain intensity, doses of systemic opioids and intrathecal morphine, and the pharmacological side effects and technical complications of intrathecal morphine administration using intrathecal catheters connected to subcutaneous injection ports in Korean terminal cancer patients with successful intrathecal morphine trials.…”