Fluoroscopy-Guided Radiofrequency Thermocoagulation of Intercostal Nerves for Management of Subcostal Pain in a Patient with Advanced Lung Cancer
林建明(Chien-Ming Lin);陳勇安(Yi-Chen Chan);詹益政(Yung-An Chen);張倍榮(Pei-Jung Chang);蔡玉娟(Yu-Chuan Tsai)
The quality of life in cancer patients is always negatively affected by pain. Patients whose pain cannot be controlled by oral analgesics or those who are not tolerate with the side effects of medications could be good candidates for interventional therapy. An appropriate neural blockade may decrease their need for oral analgesics. Here, we reported a 72-year-old man with advanced non-small cell lung carcinoma (T2N3M1), who suffered from persisted right subcostal dull pain for 3 months. Initially, the pain was adequately controlled with oral Ultracet(superscript ? (Tramadol 37.5mg/Acetaminophen325mg) three times a day. However, sharp pain developed particularly during change of position or coughing 3 months later, and was no longer managed by high-dose morphine (120 mg/d) and imipramine (30 mg/d). Due to the severely compromised pulmonary function and positive response to the diagnostic neural blockade, a fluoroscopy-guided radiofrequency thermocoagulation in the right Ti i-T12 intercostal nerves was perfoniied. The levels of pain and quality of sleep were significantly improved following the intervention.