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Fibrous mass complicating epidural morphine infusion
Neurosurgery
|January 1, 1985
Summary
Continuous epidural morphine infusion for cancer pain can cause rare catheter-related complications. A fibrous mass around the epidural catheter tip led to spinal cord displacement and neurological symptoms, requiring surgical intervention.
Area of Science:
- Neurology
- Oncology
- Pain Management
Background:
- Continuous epidural morphine infusion via implanted pumps is used for intractable cancer pain.
- Commonly discussed aspects include dosage, technique, pain relief, and tolerance.
- Anticipated complications involve surgical implantation and drug toxicity.
Observation:
- A rare complication potentially related to the epidural catheter itself is presented.
- A fibrous reaction developed around the catheter tip, forming a mass.
- This mass caused significant spinal cord displacement and long tract symptoms.
Findings:
- Myelography and computed tomography identified the abnormality.
- Prompt surgical decompression was performed.
- The patient's condition improved following the intervention.
Implications:
- This case highlights a previously undescribed complication of epidural catheter use.
- It underscores the importance of considering catheter-related issues in patients with implanted pump systems.
- Early diagnosis and surgical decompression are crucial for managing such complications and improving patient outcomes.
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