Open AccessContinuous cervical epidural analgesia in metastatic spinal cord compression
Author(s) -
Mahesh Me,
Nafisa Taha,
Navita Purohit,
Vatsal Kothari,
Sukhbir Singh
Publication year - 2016
Publication title -
indian journal of palliative care/indian journal of palliative care
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.395
H-Index - 26
eISSN - 1998-3735
pISSN - 0973-1075
DOI - 10.4103/0973-1075.191860
Subject(s) - medicine , anesthesia , spinal cord compression , spinal cord , adverse effect , surgery , sedation , local anesthetic , cancer pain , complication , catheter , cancer , psychiatry
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.