Intrathecal morphine delivery at prepontine cistern to control refractory cancer-related pain: a case report of extensive metastatic and refractory cancer pain

Abstract

Background: Extensive metastatic and refractory cancer pain is common, and exhibits a dissatisfactory response to the conventional intrathecal infusion of opioid analgesics.

Case presentation: The present study reports a case of an extensive metastatic esophageal cancer patient with severe intractable pain, who underwent translumbar subarachnoid puncture with intrathecal catheterization to the prepontine cistern. After continuous infusion of low-dose morphine, the pain was well-controlled with a decrease in the numeric rating scale (NRS) of pain score from 9 to 0, and the few adverse reactions to the treatment disappeared at a low dose of morphine.

Conclusions: The patient achieved a good quality of life during the one-month follow-up period.

Keywords: Adverse effects; Extensive metastatic and refractory cancer pain; Intrathecal delivery; Morphine; Numeric rating scale (NRS); Opioid receptors; Prepontine cistern; Subarachnoid.