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

Détails

ID Serval
serval:BIB_3B74DA52F834
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Efficacy of intrathecal bupivacaine: how important is the flow rate?
Périodique
Pain Medicine (malden, Mass.)
Auteur⸱e⸱s
Buchser E., Durrer A., Chédel D., Mustaki J.P.
ISSN
1526-2375 (Print)
ISSN-L
1526-2375
Statut éditorial
Publié
Date de publication
09/2004
Peer-reviewed
Oui
Volume
5
Numéro
3
Pages
248-252
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Oui
Création de la notice
28/01/2008 11:41
Dernière modification de la notice
20/08/2019 14:31
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