Long-Term Outpatient Epidural Analgesia in Advanced Colorectal Adenocarcinoma: A Case Report

Pain is highly prevalent among patients with advanced cancer and often remains refractory to optimized systemic analgesia. When opioid therapy fails or causes intolerable side effects, interventional techniques may offer improved symptom control and quality of life. We report the case of a 73-year-old man with metastatic colorectal carcinoma who presented with lumbar plexus compression and severe refractory gluteal pain secondary to sacral tumor invasion and infiltration of the musculotendinous structures. Despite optimized systemic analgesia, the patient continued to experience pain ≥7/10, accompanied by a progressive decline in functional status. An epidural catheter was placed and connected to a patient-controlled epidural analgesia system delivering ropivacaine. This intervention enabled home-based management with scheduled follow-up. The patient had effective pain relief, allowing for the recovery of functional capacity. Dose adjustments were made as the disease progressed. The patient remained at home with sustained analgesic benefit until his death due to cancer progression. This case supports the role of outpatient epidural analgesia as an effective and safe palliative option for selected terminal cancer patients with uncontrolled pain, particularly when mobility and quality of life can be preserved.