Cervical epidural analgesia effectively reduces headache/facial pain associated with paranasal sinus cancer invasion of the clivus: a case report

Abstract

Patients with paranasal sinus cancer occasionally present with severe headache secondary to cranial invasion. Headache and facial pain are usually treated with systemic opioids and adjuvant analgesics; however, high doses of these drugs need to be administered. We describe a patient who remained refractory to high-dose opioid therapy but was successfully treated with cervical epidural analgesia. No guidelines are available for the administration of spinal analgesia for head and neck cancer pain. However, in this case report, we have highlighted that spinally administered morphine can effectively treat headache, as well as facial and neck pain in patients refractory to conservative treatments.