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Titolo:
PERIPHERAL-NERVE CATHETERIZATION IN THE MANAGEMENT OF TERMINAL CANCERPAIN
Autore:
FISCHER HBJ; PETERS TM; FLEMING IM; EISE TA;
Indirizzi:
ALEXANDRA HOSP,DEPT ANAESTHESIA,WOODROW DR REDDITCH B98 7UB WORCS ENGLAND
Titolo Testata:
Regional anesthesia
fascicolo: 5, volume: 21, anno: 1996,
pagine: 482 - 485
SICI:
0146-521X(1996)21:5<482:PCITMO>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOCK;
Keywords:
REGIONAL ANESTHESIA; PERIPHERAL NERVE CATHETERS; CANCER-RELATED PAIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
11
Recensione:
Indirizzi per estratti:
Citazione:
H.B.J. Fischer et al., "PERIPHERAL-NERVE CATHETERIZATION IN THE MANAGEMENT OF TERMINAL CANCERPAIN", Regional anesthesia, 21(5), 1996, pp. 482-485

Abstract

Background and Objectives. Peripheral nerve catheterization techniques were used in two patients with severe pain associated with the terminal stages of metastatic cancer. The first patient had severe upper limb pain and lymphedema secondary to breast carcinoma, and the second patient had an acutely ischemic leg secondary to pelvic obstruction from an ovarian tumor. The goal of treatment was to relieve the pain, which was resistant to opioid drugs, and to optimize the quality of life that remained, estimated to be only a few weeks. Methods. The first patient received a continuous brachial plexus block via an epidural catheter, introduced by means of a Tuohy needle and a peripheral nerve stimulator to locate the plexus accurately. The second patient required catheterization of both the sciatic and femoral nerves, again with a peripheral nerve stimulator used to locate the nerves prior to insertingthe catheters. Results. Analgesia was established with a bolus of local anesthetic and maintained with a continuous infusion of local anesthetic in the first patient. For the second patient, fentanyl was addedto the local anesthetic, as it had been shown to improve analgesia inthe lower limb in previous work. Ln the first patient, the analgesia allowed active treatment of the lymphedema and mobilization of the limb, and she remained pain free until her death 2 weeks later. In the second patient, the infusions controlled the pain both before and after surgical amputation of the limb, until the stump was well healed. Conclusions. Peripheral nerve catheterization proved beneficial in two patients who presented with difficult pain management problems and shouldbe more widely considered for the relief of severe cancer-related pain in both the upper and lower limbs.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 06:22:37