Complimentary Role of Comprehensive Palliative Care Treatment to Intrathecal Therapy: Case Report

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY Journal of pain and symptom management Pub Date : 2025-01-01 DOI:10.1016/j.jpainsymman.2024.10.023
Sebastiano Mercadante MD
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Abstract

Intrathecal therapy with implanted devices is often reported in some recommendations.for the management of difficult cancer pain However, data is often biased by optimistic view and poor assessment.
We report a case of patient in which a comprehensive and complex palliative care treatment was effective in managing a patient who was implanted a subcutaneous port for intrathecal analgesia
This patient had many characteristics of a difficult pain, really defined as refractory due to various negative prognostic pain factors, such as neuropathic pain and psychological distress..
A comprehensive pain management with a balanced approach including both interventional therapy and palliative care simultaneously, allowed to achieve optimal pain control. Terms such as intractable or refractory pain, have been ambiguously used in literature to select patients as candidates for implated pumps. A meaningful evaluation and a comprehensive treatment should be mandatory when using intrathecal anlgesia in patients with very difficult pain conditions.
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综合姑息治疗在鞘内治疗中的作用:病例报告。
一些关于治疗疑难癌痛的建议中经常提到使用植入式设备进行鞘内治疗,但这些数据往往因乐观的观点和评估不足而存在偏差。我们报告了一个病例,在该病例中,综合、复杂的姑息治疗有效地控制了一名植入皮下端口进行鞘内镇痛的患者。该患者具有许多难治性疼痛的特征,真正的难治性疼痛是指由于各种不良预后疼痛因素(如神经病理性疼痛和心理困扰)导致的难治性疼痛。通过同时采用介入治疗和姑息治疗等平衡方法进行综合疼痛管理,可以达到最佳的疼痛控制效果。在选择植入泵的候选患者时,文献中对难治性或顽固性疼痛等术语的使用并不明确。在对疼痛状况非常棘手的患者使用鞘内镇痛时,必须进行有意义的评估和综合治疗。
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来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
期刊介绍: The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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