We describe the case of a 41-year-old woman with metastatic cervical cancer and a large mass eroding into the pelvis and left lumbosacral plexus. The patient had intractable left lower extremity pain refractory to standard therapies, and she elected to undergo intrathecal neurolysis. A diagnostic intrathecal block was performed at the T11-12 interspace followed by intrathecal neurolysis with 6% phenol in glycerin on a subsequent date. During both procedures, we used a tilting radiolucent orthopedic fracture table to maintain strict left lateral-supine positioning. A tilting orthopedic fracture table may be a valuable adjunct to ensure positional stability during intrathecal neurolysis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1213/XAA.0000000000000556 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Availability of, Barriers to Performing, and Educational Practices of Interventional Procedures for Refractory Pain in Cancer Patients: A Nationwide Survey of Designated Cancer Hospitals in Japan.
Palliat Med Rep
December 2024
Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Background: Because of the limitations of pharmacological therapy, nonpharmacological therapies including intervention procedures are also important for quality of cancer pain management.
Objective: To clarify the availability of, number performed, barriers to performing, and educational practices of four interventional procedures (celiac plexus neurolysis/splanchnic nerve neurolysis, phenol saddle block, epidural analgesia, and intrathecal analgesia) in designated cancer hospitals.
Design: Cross-sectional survey.
Repeated intrathecal phenol injections for cancer pain.
BMJ Support Palliat Care
July 2024
Anaesthetics and Pain Medicine, Swansea Bay University Health Board, Swansea, UK.
Intrathecal phenol neurolysis is a treatment of last resort for specific refractory cancer pains. However, there is a paucity of evidence in the academic literature and no recent documented evidence of repeat injections on the same patient. We aim to present our experience and learning from repeat interventions on the same patient in order to further the evidence base for medical professionals managing pain in a palliative care setting.
View Article and Find Full Text PDFProcedural education for cancer-related pain in Pain Medicine fellowships: a national program survey.
Reg Anesth Pain Med
June 2024
Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA
Introduction: Cancer-related pain is ubiquitous. Targeted procedural interventions may be an important and underutilized method for improving cancer-related pain and quality of life. The goal of this study was to determine the baseline educational experience and perceived post-graduation comfort of Pain Medicine fellows in performing procedures that can be used for cancer-related pain.
View Article and Find Full Text PDFEarly Interventional Treatments for Patients with Cancer Pain: A Narrative Review.
J Pain Res
May 2023
Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada.
Article Synopsis
- Between 10% and 20% of cancer patients experience pain that isn't well-controlled by standard treatments, prompting the suggestion of a "fourth step" that includes interventional methods.
- Systematic reviews indicate that early intervention can effectively manage severe cancer pain, reduce opioid use, and improve patients' quality of life.
- However, there is limited research specifically comparing the benefits of early versus late application of these procedures, necessitating a narrative overview of their potential advantages for integration into treatment guidelines.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!