Intrathecal morphine delivery at prepontine cistern to control refractory cancer-related pain: a case report of extensive metastatic and refractory cancer pain

Abstract

Abstract Background Extensive metastatic and refractory cancer pain is common, and exhibits a dissatisfactory response to the conventional intrathecal infusion of opioid analgesics. Case Presentation The present study reports a case of an extensive metastatic esophageal cancer patient with severe intractable pain, who underwent translumbar subarachnoid puncture with intrathecal catheterization to the prepontine cistern. After continuous infusion of low-dose morphine, the pain was well-controlled with a decrease in the numeric rating scale (NRS) of pain score from 9 to 0, and the few adverse reactions to the treatment disappeared at a low dose of morphine. Conclusions The patient achieved a good quality of life during the one-month follow-up period.

Keywords

• Extensive metastatic and refractory cancer pain
• Prepontine cistern
• Intrathecal delivery
• Subarachnoid
• Opioid receptors
• Numeric rating scale (NRS)