Ye Sanchun, Zhong Yubin, Yang Qingyan, Zheng Kewu, Zhang Yuenong
Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat-sen University, Yuedong Hospital, Meizhou, Guangdong 514700, P.R. China.
Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, Yuedong Hospital, Meizhou, Guangdong 514700, P.R. China.
Exp Ther Med. 2023 Apr 5;25(5):238. doi: 10.3892/etm.2023.11937. eCollection 2023 May.
Patients with advanced cancer and metastasis frequently require analgesic treatments to relieve pain and maintain an acceptable quality of life. Continuous analgesic treatment with epidural drug infusion is one interventional approach to provide adequate pain relief. Most epidural analgesia procedures are performed with the catheter inserted in the lower thoracic or lumbar spine areas, which is then advanced in a cephalad direction to reach the level that requires analgesia. The present study reported on a patient with chest and upper back pain who failed oral oxycodone treatment. Epidural analgesia to target the T5 level was planned. However, a lower spinal puncture with cephalad advance of the catheter was not possible due to metastasis and compression in the T5-8 levels. Thoracic spine puncture was performed between the T1 and T2 vertebrae and the infusion catheter was advanced in a caudal direction to reach the T5 level. Successful pain relief and amelioration of clinical symptoms demonstrated that the method may be considered a feasible and safe approach to achieve adequate analgesia and improve the quality of life of patients with similar conditions.
晚期癌症和转移患者经常需要镇痛治疗来缓解疼痛并维持可接受的生活质量。硬膜外药物输注持续镇痛治疗是一种提供充分疼痛缓解的介入方法。大多数硬膜外镇痛程序是将导管插入下胸段或腰段脊柱区域，然后向头侧推进以到达需要镇痛的水平。本研究报告了一名口服羟考酮治疗失败的胸部和上背部疼痛患者。计划对T5水平进行硬膜外镇痛。然而，由于T5-8水平的转移和压迫，无法进行低位脊柱穿刺并向头侧推进导管。在T1和T2椎体之间进行胸椎穿刺，并将输注导管向尾侧推进以到达T5水平。成功的疼痛缓解和临床症状改善表明，该方法可被认为是一种可行且安全的方法，以实现充分镇痛并改善类似病情患者的生活质量。
