[Neurolysis and Spinal Analgesia in Cancer Pain Management]

Cancer pain appears as a complex pain and often progressive.WhenWHO pain management strategy and/or palliative care failed to relieve their pain, patients are given high dose opioids or anonymous adjuvant drugs and have no chance to meet specialized pain treatment. This section briefly covers the outline of neurolysis and spinal analgesia for these cancer patients with severe pain. Purpose of nerve block and neurolysis are to block the incoming signal of pain in order to reduce pain, reduce analgesic dose, recover ADL, and finally to be discharged from the hospital. However, autonomic nervous system, sensory nerves, and motor function could be impaired at the same time. Careful selection of candidate should be considered by the pain specialists. Spinal analgesia is indicated when, conservative pain treatment failed to reduce pain, wide range or multiple pain area, and when contraindicated for neurolysis. Epidural analgesia is preferred for in-hospital treatment and intrathecal analgesia for home care settings. Many cancer pain patients' life expectancy is not long enough to postpone the indication of these invasive techniques. If you seek to maintain patients' quality of life(QOL), one should consider these procedures at some point, although it may not be indicated.