First Evaluation Switching From Ropivacaine to Highly Concentrated Bupivacaine in Intrathecal Mixtures for Cancer Pain

Bienfait, Florent; Jubier-Hamon, Sabrina; Seegers, Valérie; Pluchon, Yves-Marie; Lebrec, Nathalie; Jaoul, Virginie; Boré, François; Delorme, Thierry; Robert, J.; Bellanger, Martine; Sorrieul, Jérémy; Dupoiron, Denis

doi:10.1111/ner.13469

Cited by 5 publications

(1 citation statement)

References 41 publications

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“…No relevant hypotensive effects were recorded 14. In a further step, doses of bupivacaine were increased, while morphine doses were decreased 15. This intervention did not alter the neurological deficit that was already established.…”

Section: Discussionmentioning

confidence: 98%

When the game is hard, more complex weapons are needed

Mercadante

Adile

Ferrera

et al. 2022

BMJ Support Palliat Care

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ObjectivesThe aim of this paper is to illustrate how to manage a very difficult pain condition.MethodsThis is a clinical note of a complex approach using multiple analgesic regimens to effectively afford challenging pain situations.ResultsA man underwent an opioid dose titration, followed by dose stabilisation for some months. Then he underwent two opioid substitutions, unsuccessfully. A spinal analgesia provided good analgesia for a prolonged period of time, necessitating variable interventions to counteract the evolving, challenging clinical situation.ConclusionsThe description of this case illustrates the need of a high level of experience and knowledge to elaborate complex strategies step by step every time the pain syndrome was worsening. Recommendations are unlikely in these extreme circumstances, and treatment should be based on continuous clinical counteraction to the evolving clinical conditions.

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Section: Discussionmentioning

confidence: 98%