Clinical case of using of implantable spinal access port system

Abstract

This paper presents our experience of implantation and operation of the spinal access port system on the example of patient P, 78 years old. The admission diagnosis: malignant neoplasm of pancreas. Surgical treatment is contraindicated due to multiple metastases to the abdominal organs and lymph nodes. On admission to the hospital, the patient complained of persistent abdominal pain [6–8 points on Visual Analog Scale for Pain (VAS Pain)] was not relieved by the injection of NSAIDs and narcotic analgesics (morphine hydrochloride). We have decided to implant the spinal access port system to the patient aimed at neuraxial analgesia techniques. According to the World Health Organization (WHO), about 3.5 million people every day around the world suffer from cancer-related pain every day. The difficulties associated with the ineffectiveness of traditional pharmacological interventions for pain management lead to search alternative pain management. One of the aims of the paper is to attract the attention of treating doctors, surgeons, anesthesiologists to this technique because since it allows to reduce or relief of pain in this group of patients and improve their quality of life.

Keywords

spinal access port system / malignancy of pancreas / relief of pain

References

[1] Kryzhanovsky G.N. Physiological and pathological pain. Pathogenesis. 2005; 3 (1): 14. (In Russ.)

[2] Крыжановский Г.Н. Физиологическая и патологическая боль. Патогенез. 2005; 3 (1): 14.

[3] Novikov G.A., Chissov V.I. Palliativnaya pomoshch' onkologicheskim bol'nym. (Palliative care for cancer patients.) M.: Medicine for quality of life. 2006; 192 р. (In Russ.)

[4] Новиков Г.А., Чиссов В.И. Паллиативная помощь онкологическим больным. М.: Медицина за качество жизни. 2006; 192 с.

[5] Garbuzov E.Yu., Kaptsov S.V. Implantation of spinal (epidural) access port systems. Sestroretsk. 2016. https://www.gb40.ru/services/centr/article/imp-port-sistem/ (access date: 15.01.2020). (In Russ.)

[6] Гарбузов Е.Ю., Копцов С.В. Имплантация спинальных (эпидуральных) порт-систем. Сестрорецк. 2016. https://www.gb40.ru/services/centr/article/imp-port-sistem/ (дата обращения: 15.01.2020).

[7] Ratsional'naya farmakoanesteziologiya. Rukovodstvo dlya praktikuyushchikh vrachey. (Rational pharmacoepide­miology. Hands. for medical practitioners.) Ed. by A.A. Bunatyan, V.M. Mizikova. M.: Littera. 2006; 800 р. (In Russ.)

[8] Рациональная фармакоанестезиология. Руководство для практикующих врачей. Под общ. ред. А.А. Бунатяна, В.М. Мизикова. М.: Литтера. 2006; 800 с.

[9] Merskey H. Taxonomy and classification of chronic pain syndromes. In: Benzon H.T., Rathmell J.P., Wu C.L. et al. Raj’s practical management of pain. Philadelphia: Elsevier. 2008; 13–18. DOI: 10.1016/b978-0-323-08340-9.00002-5.

[10] Principles and practice of pharmacology for anaesthetists. Fourth edition. Ed. by T.N. Calvey, N.E. Williams. Wiley, John & Sons, Inc. 2007; 352 р. (Russ. ed.: Farmakologiya dlya anesteziologa. Kn. 1. Farmakokinetika. Farmakodinamika. Anestetik. Miorelaksanty. Antikaogulyanty. Ed. by V.N. Mizikova, A.M. Tseytlina. M.: Binom. 2007; 178 p.

[11] Калви Т.Н. Фармакология для анестезиолога. Кн. 1. Фармакокинетика. Фармакодинамика. Анестетик. Миорелаксанты. Антикаогулянты. Пер. с англ. Под ред. В.Н. Мизикова, А.М. Цейтлина. М.: Бином. 2007; 178 с.

[12] Wong C.A. Spinal and epidural anesthesia. New York: McGraw-Hill Medical. 2007; 374 р.

RIGHTS & PERMISSIONS

Bondarenko S.Y., Gureev A.D., Trukhanov I.G.