Analgesia for pelvic and perineal cancer pain by intrathecal steroid injection.

BACKGROUND

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.

CASE REPORT

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.

CONCLUSIONS

Intrathecal injection of betamethasone may be a useful approach in some patients with intractable cancer pain.