Tumber Paul S, Fitzgibbon Dermot R
Pain Service and Department of Anesthesiology, University of Washington, School of Medicine, Box 356540, Seattle, WA 98195, USA.
Pain. 1998 Dec;78(3):217-220. doi: 10.1016/S0304-3959(98)00133-X.
The management of severe cancer pain may be problematic in spite of recent advances in pain management. A small percentage of patients with severe intractable pain and/or intractable side effects may require more aggressive interventional pain management strategies including the administration of medications continuously by the intrathecal route. A variety of medications, including morphine, bupivacaine, and clonidine, may be used intrathecally for the control of cancer pain. Optimal use of these medications requires individual titration to the patient's needs. We describe a case of severe cancer pain where these medications were used successfully by continuous intrathecal infusion and patient controlled intrathecal analgesia.
尽管疼痛管理方面最近有所进展，但严重癌症疼痛的管理仍可能存在问题。一小部分患有严重顽固性疼痛和/或顽固性副作用的患者可能需要更积极的介入性疼痛管理策略，包括通过鞘内途径持续给药。多种药物，包括吗啡、布比卡因和可乐定，可通过鞘内给药用于控制癌症疼痛。这些药物的最佳使用需要根据患者的需求进行个体化滴定。我们描述了一例严重癌症疼痛的病例，其中通过持续鞘内输注和患者自控鞘内镇痛成功使用了这些药物。
