Caudal Neuraxial Blocks for Pain Relief From Pelvic Neuropathy Caused by Extensive Diffuse Large B-cell Lymphoma.
| Autor: | Myles A; Internal Medicine, Piedmont Athens Regional, Athens, USA.; Anesthesiology, Boston Medical Center, Boston, USA., Toubasi A; Anesthesiology and Perioperative Medicine, Augusta University Medical College of Georgia, Augusta, USA., Soladoye E; Internal Medicine, Piedmont Athens Regional, Athens, USA., Gowda N; Pulmonary and Critical Care, Piedmont Athens Regional, Athens, USA., Morny J; Internal Medicine, Piedmont Athens Regional, Athens, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2024 Jan 23; Vol. 16 (1), pp. e52807. Date of Electronic Publication: 2024 Jan 23 (Print Publication: 2024). |
| DOI: | 10.7759/cureus.52807 |
| Abstrakt: | Central neuraxial blocks can be a vital therapeutic tool for neuropathic pain, but they are infrequently implemented for pain management in cancer patients. Upon a literature review, further data on the role or efficacy of central nerve blocks for neuropathic cancer pain would be beneficial. Additionally, evidence-based guidelines and practices are lacking regarding additional interventions for neuropathic pain relief, a common manifestation of cancer burden. Here, we report the case of a 29-year-old male patient who presented in the ED with intractable neuropathic pain from extensive diffuse large B-cell lymphoma. The patient demonstrated left lower extremity pain, fevers, chills, and tenderness with erythema over the site of his port-a-catheter on his chest. The patient was also hypotensive, despite IV fluid resuscitation. Recent imaging showed a hypermetabolic soft tissue mass in the left upper quadrant of the abdomen. There was also extensive cancer spread in the peripheral pelvis, presacral region, and within multiple sacral foramina, with a secondary perineural spread of the tumor. The patient previously positively responded to a caudal nerve block at an outpatient pain clinic. The patient was admitted to the ICU for three days, and following the resolution of sepsis, the patient received caudal and sciatic nerve blocks on admission day 8. Upon further imaging showing metastasis to the brain, the patient was discharged to inpatient hospice on hospitalization day 10 following a palliative conversation with the patient and family. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Myles et al.) |
| Databáze: | MEDLINE |
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