Review article
https://doi.org/10.20471/acc.2022.61.s2.14
Palliative Treatment of Intractable Cancer Pain
Lidija Fumić Dunkić
; Division of Anesthesiology, Intensive Care and Pain Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Vedran Hostić
; Division of Anesthesiology, Intensive Care and Pain Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Antonia Kustura
; Division of Anesthesiology, Intensive Care and Pain Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
In 10% to 30% cancer-pain cases standard analgesic therapy fails to provide effective
pain relief. Interventional techniques, such as peripheral nerve blocks, neuraxial analgesia along
with neurolytic blocks may be used for such refractory pain. Peripheral nerve blocks can be used when
pain occurs in the territory of one or more peripheral nerves, but rarely as main therapy. Neuraxial
analgesia is a valid option for progressive cancer pain, and healthcare possibilities and costs call into
question the utility of intrathecal infusion pumps. Neurolysis is the targeted destruction of a nerve or
nerve plexus, using chemicals, radiofrequency ablation (RFA), cryoablation, and neurosurgical procedures;
however, it rarely completely eliminates pain because patients frequently experience coexisting
somatic and neuropathic pain as well. Complex conditions of palliative patients along with limited
high-quality randomized controlled trials limit the use of interventional procedures. Even so, some
cancer patients benefit from interventional procedures to achieve pain alleviation and consequently
improve quality of life.
Keywords
Palliative care; Cancer pain; Refractory pain; Nerve block; Spinal Anesthesia; Neurolysis
Hrčak ID:
284406
URI
Publication date:
1.9.2022.
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