Consideration of the Role of Ward Pharmacist Found by Working with the Palliative Care Team

－Through a Case in which Intravenous Injection Lidocaine Resulted in Dramatically Improvement in Neuropathic Pain－

Abstract

Case report: The 33 year-old male patient suffered from neuropathic pain on his right leg caused by metastatic retroperitoneum after surgical removal of sigmoid colon cancer. Although he was treated with a transdermal fentanyl patch, immediate release oxycodone, flurbiprofen, paracetamol, and pregabalin, his breakthrough pain and fulminant pain were not improved. Afterward, as oral medicine administration became difficult due to obstructive ileus, and the opioid was changed from transdermal fentanyl patch to fentanyl injection, but there was no improvement. Then, the ward pharmacist and palliative care team discussed an analgesic adjuvant, and decided to inject lidocaine to the patient. The injection caused the patient's condition to dramatically improve. By giving drug information to the ward team and carrying on pain assessment, the ward pharmacist contributed to lessening the patient's pain and the shift to the home medical care. The ward pharmacist joining in the team medical care widened the scope of information sharing. As a result, the medical team was able to realize medical therapy in accordance with the patients wish.