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Epidural Analgesia for End-of-Life Pain
Sandy Christiansen1, Marissa Mayeda1, Jacob Mazzola1
1Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Journal of Palliative Medicine
|October 25, 2024
Summary
Tunneled epidural analgesia offers a potential solution for managing intractable pain in hospice patients, reducing reliance on oral opioids. This method may be underutilized in end-of-life care, warranting further investigation.
Area of Science:
- Palliative Care
- Pain Management
- Anesthesiology
Background:
- Epidural anesthesia is common for labor and perioperative pain but underused in hospice.
- Hospice patients with intractable pain often rely on oral opioids.
- Tunneled epidural analgesia presents an alternative for advanced pain management.
Purpose of the Study:
- To describe the use and outcomes of tunneled epidural analgesia in hospice patients with intractable pain.
- To evaluate the effectiveness of tunneled epidural analgesia in reducing opioid requirements.
Main Methods:
- Retrospective review of seven hospice patients who received tunneled epidural analgesia.
- Data collected included medication infused, adverse effects, oral morphine equivalents (OME), pain scores, blood pressure, and heart rate.
- Analysis focused on changes in OME and pain scores post-intervention.
Main Results:
- Seven patients received tunneled epidural placement for pain management.
- The average reduction in oral morphine equivalents (OME) was 122.73 mg.
- Tunneled epidural analgesia demonstrated potential for pain control and opioid reduction.
Conclusions:
- Tunneled epidural analgesia may be an underutilized option for end-of-life pain management.
- Further research is needed to establish the effectiveness, safety, and implementation barriers.
- This technique could improve quality of life for hospice patients with severe pain.
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