Patient-controlled analgesia using ropivacaine via an intrathecal catheter

A 38-year-old woman presented with severe intractable pain in the sacral and perirectal areas secondary to metastatic stage I.B. squamous cell carcinoma of the cervix.

An indwelling epidural catheter was placed to control the patient's symptoms after failure of conservative therapies. Finally, an infusion containing isobaric 0.2% ropivacaine with 0.002% preservative-free morphine and 0.0002% epinephrine was started to treat her pain and preserve motor function to preserve quality of life.

The patient obtained good pain relief with this regimen and was discharged home. She was able to walk with assistance and maintain good quality of life until her death approximately 7 weeks after the placement of the indwelling epidural catheter.

The use of ropivacaine in combination with other analgesics, via an intrathecal catheter for patient-controlled analgesia, was an effective treatment for this patient. In the future, ropivacaine administered epidurally or intrathecally alone, or in combination with other analgesics, may become the local anesthetic of choice due to its preservation of motor function. Certainly, further scientific studies are indicated in the cancer patient population.