Abstract

CARVAJAL-VALDY, Gabriel  and  DUPOIRON, Denis. Intrathecal drug delivery system for medically refractory cancer pain treatment. Acta méd. costarric [online]. 2018, vol.60, n.1, pp.53-57.  Epub Mar 01, 2018. ISSN 0001-6002.

Cancer is the second cause of death in Costa Rica and a high percentage of cancer patients have pain due to their illness. Different strategies allow offering pain relief in high complexity cases in which medical management does not meet treatment goals. We present an illustrative case of a patient with esophageal cancer and severe cancer related pain refractory to comprehensive medical management. Intrathecal combination therapy (morphine, ziconotide, ropivacaine) was offered through an implantable intrathecal analgesia system. This strategy allowed obtaining quickly an adequate and sustained pain control with an improvement in patient’s functional status. Clinical findings and imaging studies are discussed.

In this case, intrathecal analgesia proved to be an effective option to adequately treat pain in a patient with severe cancer pain refractory to comprehensive medical management. A multimodal approach to cancer pain management is necessary and this minimally invasive technique should be considered in complex cases of cancer pain.

Keywords : Pain management; Cancer; Infusion Pumps, Implantable; Infusion, spinal; Palliative medicine.

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