Abstract
We report two cases of refractory cancer pain successfully treated with intrathecal injections (IT) of a high dose of bupivacaine (BPV) in combination with morphine. Case 1: A 72-year-old male with lower limb pain resulting from iliopsoas and femoral muscle metastasis of lung cancer was treated with IT of BPV (maximum dose of 94 mg/day) and morphine, which decreased pain severity from 4 to from 1 to 2 on the verbal rating scale. Case 2: A 64-year-old female with pain around the genital area because of skin metastasis of rectal cancer was treated with IT of BPV (maximum dose of 66 mg/day) and morphine, which decreased pain severity from 10 to from 2 to 5 on the numerical rating scale. Although lower limb numbness and hypotension were developed after an injection of rescue dose, it subsided with the dose adjustment. The use of high-dose IT of BPV in combination with morphine may be useful for patients suffering from refractory cancer pain.
