Taguchi H, Shingu K, Okuda H, Matsumoto H
Department of Anesthesiology, Kansai Medical University, Moriguchi, Osaka 570-8506, Japan.
Acta Anaesthesiol Scand. 2002 Feb;46(2):190-3. doi: 10.1046/j.0001-5172.2001.00000.x-i1.
Corticosteroids are used systemically in patients with advanced cancer to alleviate pain. Intrathecal administration of steroids is rarely performed but analgesic effects of intrathecal steroids have been reported in animal studies. We administered betamethasone intrathecally in three cancer patients with uncontrollable pain.
Intrathecal injection of betamethasone (1-4 mg) with saline (total volume = 2 mL) was performed in three patients with advanced pelvic or perineal cancer, in whom pain could not be controlled in spite of various analgesic therapies. After obtaining the patient's informed consent for the procedure, betamethasone was administered intrathecally through the L4/5 intervertebral space. Intrathecal betamethasone produced rapid analgesia within 10 min and subsequent long-lasting analgesia for 5 days or more. Sleep, appetite and activity improved. No adverse effects were observed in any of the patients.
Intrathecal injection of betamethasone may be a useful approach in some patients with intractable cancer pain.
晚期癌症患者会全身使用皮质类固醇来缓解疼痛。鞘内注射类固醇很少进行，但动物研究已报道鞘内类固醇具有镇痛作用。我们对三名疼痛无法控制的癌症患者进行了鞘内注射倍他米松。
对三名晚期盆腔或会阴癌患者进行了鞘内注射倍他米松（1 - 4毫克）加生理盐水（总体积 = 2毫升），尽管采用了各种镇痛疗法，这些患者的疼痛仍无法得到控制。在获得患者对该操作的知情同意后，通过L4/5椎间隙进行鞘内注射倍他米松。鞘内注射倍他米松在10分钟内产生快速镇痛效果，随后产生持续5天或更长时间的长效镇痛。睡眠、食欲和活动均有所改善。所有患者均未观察到不良反应。
鞘内注射倍他米松可能是一些难治性癌症疼痛患者的有效治疗方法。
