Efficacy of intrathecal bupivacaine: how important is the flow rate?

Details

Serval ID
serval:BIB_3B74DA52F834
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Efficacy of intrathecal bupivacaine: how important is the flow rate?
Journal
Pain Medicine (malden, Mass.)
Author(s)
Buchser E., Durrer A., Chédel D., Mustaki J.P.
ISSN
1526-2375 (Print)
ISSN-L
1526-2375
Publication state
Published
Issued date
09/2004
Peer-reviewed
Oui
Volume
5
Number
3
Pages
248-252
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
We present two cases of cancer patients with intractable mechanical and visceral pain that was unrelieved with either comprehensive medical management or intrathecal morphine who received intrathecal bupivacaine. While the continuous administration of a seemingly significant daily dose neither relieved pain nor caused measurable clinical changes, the addition of small, presumably negligible bolus doses on top of the continuous infusion resulted in spectacular pain control, clear thermoanalgesic suspended block, and in one of the patients, significant hypotension. To the best of our knowledge, such an observation has neither been reported before nor can we provide a satisfactory explanation for it. However, we believe it may have significant implications for the treatment of some patients, in particular, cancer patients with mechanical pain that cannot be adequately relieved with morphine whatever the route of administration.
Keywords
Aged, Anesthetics, Local/administration & dosage, Bupivacaine/administration & dosage, Dose-Response Relationship, Drug, Female, Humans, Infusion Pumps, Implantable, Injections, Spinal/instrumentation, Injections, Spinal/methods, Middle Aged, Neoplasms/complications, Neoplasms/diagnosis, Pain, Intractable/diagnosis, Pain, Intractable/drug therapy, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 11:41
Last modification date
20/08/2019 14:31
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