PMID: 8602655Feb 1, 1996Paper

Continuous intracisternal and high cervical intrathecal bupivacaine analgesia in refractory head and neck pain

Anesthesiology
L AppelgrenI Curelaru

Abstract

The upper cervical component of the spinomesencephalic tract and cranial nerves V, VII (nervus intermedius), IX, and X are involved in mechanisms of acute and chronic pain from head and neck structures. To date there is no reliable method for relief of refractory pain (i.e., pain that cannot be relieved by conventional pharmacologic therapies) from these structures. Therefore, we explored continuous intracisternal infusion of bupivacaine for the treatment of refractory pain of the head and neck. Intracisternal catheters were inserted in 13 adults with refractory nonmalignant (n = 4) and malignant (n = 9) pain from the head, face, mouth, neck, and upper extremities; 0.5% plain bupivacaine was infused continuously at rates of 1-7 (median 1.5) mg/h with optional bolus doses of 0.5-2.0 mg 4-2 times/h. The efficacy was assessed from pain relief (daily VAS(max), VAS(min), and VAS(mean) scores 0-10), daily doses of intracisternal bupivacaine and total opioid (expressed as mg parenteral morphine-eq), amount of nocturnal sleep, and rates of adverse effects. The 13 patients were treated for 3-182 days (median 37, total 712 days), 3 patients being treated at home for 10-112 days (median 88, total 210 days). In one patient, the efficacy of...Continue Reading

References

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Citations

Apr 1, 1999·Neuromodulation : Journal of the International Neuromodulation Society·S J HassenbuschP Nitescu
Jul 1, 2002·Neuromodulation : Journal of the International Neuromodulation Society·Manuel Juliá NarváezBernarda Márquez Márquez
Jan 1, 1998·Neuromodulation : Journal of the International Neuromodulation Society·M SchuchardR Lanning
May 23, 2002·Regional Anesthesia and Pain Medicine·Theodore S Grabow, Patrick M Dougherty
Sep 16, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Eric BuchserJean-Pierre Mustaki
Oct 29, 2005·The Journal of Physiology·Gavin LambertPetre Nitescu
Apr 25, 2007·Disability and Rehabilitation·Lorraine H De Souza, Andrew O Frank
Nov 30, 2004·Cancer Investigation·Oscar A de Leon-Casasola
Dec 20, 2007·Oral and Maxillofacial Surgery Clinics of North America·Sukdeb Datta, Umeshraya T Pai
Jan 15, 2004·Anesthesiology Clinics of North America·Hollie NguyenSamuel J Hassenbusch
Dec 22, 1999·Anesthesiology·P M Dougherty, P S Staats
May 22, 2009·Acta Anaesthesiologica Scandinavica·C LundborgB Biber
Jun 29, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Florent BienfaitDenis Dupoiron

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