Successful continuous 32‐day epidural analgesia in a pregnant woman with cervical cancer

Abstract

A 36-year-old pregnant lady was admitted at 26 weeks gestation with abdominal pain radiating to the groin and back. Physical examination, biopsy of the cervix and magnetic resonance imaging (MRI) confirmed cervical carcinoma. As the patient wished to continue with the pregnancy, a decision was made to perform elective caesarean section at 34 weeks. Due to persistent severe pain despite systemic analgesics, the decision to insert a tunnelled epidural catheter was made in order to provide long term analgesia. Repeated boluses of 0.2% ropivacaine or 0.2-0.25% bupivacaine with morphine, depending on numerical rating scale (NRS) values, were administered. Co-medication consisted of intravenous acetaminophen. Preterm delivery by caesarean section at 32 weeks gestation was performed because the patient went into labour. The epidural catheter was in situ for 32 days with no complications.