Maeda Aiko, Watanabe Masatsugu, Saigano Chiaki, Nakayama Shoko, Yamaura Ken
Operating rooms, Kyushu University Hospital, 3-1-1 Maedashi Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan.
JA Clin Rep. 2020 Oct 6;6(1):78. doi: 10.1186/s40981-020-00386-9.
Patients with malignant pleural mesothelioma (MPM) frequently complain of intractable pain that is resistant to conservative treatments. Although spinal cord stimulation (SCS) may be promising in the alleviation of such devastating pain, the effects of SCS on MPM-associated pain and the appropriate timing of its application remain unknown.
A 66-year-old man diagnosed with MPM presented with severe neuropathic pain due to rapid progression of the tumor to the intercostal nerves. The patient immediately decided to receive SCS implantation and burst stimulus, which relieved the conservative therapy-resistant pain and improved his sleep and daily activities.
This report suggests that the execution of SCS as soon as possible may help to alleviate MPM symptoms. Since MPM extends aggressively to the thorax and nerves that cause mixed nociceptive and/or neuropathic pain, appropriate pain management requires the proper assessment of the etiology by an expert in pain management.
恶性胸膜间皮瘤（MPM）患者经常抱怨存在难以治疗的疼痛，这种疼痛对保守治疗无效。尽管脊髓刺激（SCS）在缓解此类严重疼痛方面可能具有前景，但SCS对MPM相关疼痛的影响及其应用的合适时机仍不清楚。
一名66岁被诊断为MPM的男性患者，因肿瘤迅速侵犯肋间神经而出现严重的神经性疼痛。该患者立即决定接受SCS植入和爆发刺激，这缓解了对保守治疗有抵抗性的疼痛，并改善了他的睡眠和日常活动。
本报告表明，尽早实施SCS可能有助于缓解MPM症状。由于MPM会迅速侵犯胸部和神经，导致混合性伤害性和/或神经性疼痛，适当的疼痛管理需要疼痛管理专家对病因进行恰当评估。
