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High-tech pain management utilizing multiple analgesics--a case study

R R Pickett, S J Secor

    The American Journal of Hospice & Palliative Care
    |January 1, 1995
    PubMed
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    Intraspinal opioid infusions offer effective pain management for severe cancer pain, minimizing side effects. This case study highlights the multidisciplinary approach needed for challenging pain cases using spinal analgesia and multiple medications.

    Area of Science:

    • Pain Management
    • Oncology
    • Pharmacology

    Background:

    • Intraspinal opioid delivery is a validated therapy for severe cancer pain.
    • Spinal opioid infusions provide effective analgesia with reduced central side effects compared to systemic administration.

    Observation:

    • Indications include escalating side effects or inadequate pain relief with oral/parenteral opioids.
    • A challenging case required a multidisciplinary approach involving intraspinal morphine, intravenous hydromorphone, and intravenous midazolam.

    Findings:

    • Effective management of intractable cancer pain was achieved through a combination of intraspinal analgesia and multiple intravenous medications.
    • The patient's complex pain required a tailored, multi-drug regimen.

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    Implications:

    • Oncology and hospice nurses face challenges in managing spinal analgesia and complex medication regimens.
    • This approach offers an effective modality for patients with otherwise intractable cancer pain, improving quality of life.