[Bilateral interpleural analgesia in a patient with multiple myeloma]

The case of one patient with multiple myeloma and thoracic pain during myeloptysis is described. Bilateral interpleural analgesia was accomplished with 10 ml of 0.375% bupivacaine with adrenaline (5 micrograms/ml) in both hemithorax and bilateral infusion at a rate of 3 ml/h started immediately and maintained during 24 hours. Analgesia was then obtained by means of a bolus pattern 10 ml/6 h until myeloptysis finished. Analgesic effectiveness was evaluated through visual analogue scale (VAS). Plasmatic levels of bupivacaine were found below toxic levels; maximum concentration was (1.12 microgram/ml) at the steady state (5 x t 1/2). Difficulty in treatment of pain and utility of interpleural analgesia is suggested.