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| Category #26 - Chronic pain topics |
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| Question: |
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I have had an enquiry from a pain doc at the leading London cancer hospital about the use of brachial plexus catheters for controlling cancer pain caused by malignant infiltration of the brachial plexus (lower roots) - usually secondary to metastatic breast cancer. These patients have tried all conventional analgesics but still have persistent intractable neuropathic pain. He would need to leave the catheters in place for at least a week - ideally longer. Any ideas?
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There is a very easy and good solution and obvious to the problem. You obviously have to go proximal to the plexus infiltration, so I would like to suggest a continuous cervical paravertebral block. This can stay in for months and should give the patient complete sensory and perhaps a 30 - 40% motor block. We have left one in place for three months with excellent results.
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