A case of pancreatic cancer pain treated with splanchnic nerve block and intrathecal analgesia leading to home medical care

Abstract

An 80-year-old male with cancer pain due to pancreatic cancer underwent splanchnic nerve block twice to manage abdominal and lower back pain. Due to persistent pain, an intrathecal catheter and a subcutaneous access port (intrathecal port, IT port) were placed for continuous analgesic administration. Intrathecal morphine was initiated at a dose of 1.2 mg/day. The patient was discharged five days after IT port placement. Three days post-discharge, he was visited by the pain management team due to increasing pain. At this time, the intrathecal morphine dose was increased to 6.0 mg/day. The patient passed away peacefully and painlessly at home, seven days after discharge. Intrathecal analgesia is a valuable technique for delivering neuraxial analgesia in a home setting. We report a case in which the patient was able to remain at home while receiving weekly management of intrathecal analgesia by our staff, in conjunction with general home medical care provided by a visiting physician.