Abstract
Although recent studies show that thoracic paravertebral block (TPVB) provides similar pain relief with lesser adverse effects compared with epidural analgesia after thoracic surgery, there are few reports of TPVB for cancer pain relief. We present a case of successful pain management with the combination of opioid, ultrasound-guided TPVB, and radiation therapy in a woman suffering from intractable chest pain with lung cancer. In this case, a tumor extended to the middle thoracic area and dissemination of the lower pleura. TPVB was performed twice. During ultrasound-guided TPVB, fluoroscopy was used to confirm the spread of injected solution after the ultrasound-guided needling and to determine the dose of 100% alcohol. Her pain was reduced, and she had spent 6 months at home after the block. In conclusion, ultrasound-guided TPVB can be applied to thoracic cancer pain, and we recommend the use of fluoroscopy to provide adequate analgesia and to minimize adverse effects.
