-Abstract-
Since 1979 forty-three cancer patients have been given intrathecal block at the pain
clinic of Yonsei Medical Center. The male patients numbered 23 and female 20 and most
of them were in the 4th and ruth decades of age.
In 78.6% of the patients, the diagnosis was rectal cancer in 20 cases, cervix cancer in
7 cases, bladder cancer in 4 cases and colon cancer in 3 cases.
Thirty six patients with cancer pain were treated by intrathecal 10% phenol-glycerine
block and rest of them had only test block.
Fourteen patients whose pain sites were lumbar or lumbar and upper sacral
dermatomes were put into the lateral recumbent position on the fluoroscopic table. The
spinal puncture was performed as close to the spinal roots to be impregnated as
possible. In 22 patients the pain sites were covered by the sacral dermatomes and so
the L5-S1 interspace was punctured in the sitting position shifted 15 degree to the
affected site.
Fifty one blocks were performed and their results are classified into three categories:
good, fair antral poor.
We achieved good results in 38 patients(77.1%), fair in 6 patients(17.1%) and poor in
2 patient(5.7%). Thus a satisfactory pain relief was achieved in 94,2% of patients. After
intrathecal block with phenol glycerine, transient voiding difficulty was noted in 7,
defecation difficulty in 1, and transient paresthesia and/or muscle weakness was present
in 3 patients.
The mean duration of pain relief was 2. 5 months and longer than the mean survival
time of 2.25 months.
When patients are selected carefully and tile block is performed with great caution
and good technique, the risk is minimal and a long lasting relief of intractable cancer
pain achieves a painless life until death.
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