Ambulante Schmerztherapie. Behandlung bei penetrierendem Rektum-Karzinom mittels Periduralkatheter

Zusammenfassung

Im Rahmen der Tumorschmerztherapie kommen immer wieder auch invasive Techniken zum Einsatz. Wir berichten über die Schmerztherapie bei einer 55-jährigen Patientin mit penetrierendem Rektum-Karzinom mittels kontinuierlicher lumbaler Periduralanästhesie. Nach Anlage und Einstellung im Krankenhaus erfolgte die weitere Behandlung über insgesamt 7 Wochen im häuslichen Umfeld.

Abstract

Treatment of cancer pain includes invasive techniques of pain therapy if necessary. Here we report the management of a 55-year-old female patient with penetrating rectal cancer using continous lumbal epidural anesthesia. After placement and dose-finding our patient was discharged from hospital and further treatment occured at home.

Ambulante Schmerztherapie - palliativ - Periduralkatheter - Rektum-Karzinom

Ambulatory pain therapy - palliative - peridural catheter - rectal cancer

Literatur

• 1 Bonica JJ.. Cancer Pain.. In: Fibiger L, (Hrsg.) The Management of Pain.. London/Philadelphia; 1990: 400-460
• 2 Schug SA, Zech D, Dorr U.. Cancer pain management according to WHO analgesic guidelines.  J Pain Symptom Manage. 1990;  5 27-32
• 3 Miguel R.. Interventional treatment of cancer pain: the fourth step in the World Health Organization analgesic ladder?.  Cancer Control. 2000;  7 149-156
• 4 Jocham HR, Dassen T, Widdershoven G et al.. Quality of life in palliative care cancer patients: a literature review.  J Clin Nurs. 2006;  15 1188-1195
• 5 McNicol E, Horowicz-Mehler N, Fisk RA et al.. Management of opioid side effects in cancer-related and chronic noncancer pain: a systematic review.  J Pain. 2003;  4 231-256
• 6 Ohnesorge H, Siebrecht D, Gleim M.. Tumor pain therapy.  Anasthesiol Intensivmed Notfallmed Schmerzther. 2003;  38 (Quiz 435–437)
• 7 Kress HG.. Clinical update on the pharmacology, efficacy and safety of transdermal buprenorphine.  Eur J Pain. 2009;  13 219-230
• 8 Downing JE, Busch EH, Stedman PM.. Epidural morphine delivered by a percutaneous epidural catheter for outpatient treatment of cancer pain.  Anesth Analg. 1988;  67 1159-1161
• 9 Smitt PS, Tsafka A, Teng-van de Zande F et al.. Outcome and complications of epidural analgesia in patients with chronic cancer pain.  Cancer. 1998;  83 2015-2022
• 10 Ruppen W, Derry S, McQuay HJ, Moore RA.. Infection rates associated with epidural indwelling catheters for seven days or longer: systematic review and meta-analysis.  BMC Palliat Care. 2007;  6 3
• 11 Crul BJ, Delhaas EM.. Technical complications during long-term subarachnoid or epidural administration of morphine in terminally ill cancer patients: a review of 140 cases.  Reg Anesth. 1991;  16 209-213