Upper thoracic spine puncture and caudal advance of an epidural catheter for adequate analgesia in a patient with breast cancer with chest and upper back pain: A case report

Ye,Sanchun; Zhong,Yubin; Yang,Qingyan; Zheng,Kewu; Zhang,Yuenong

doi:10.3892/etm.2023.11937

Upper thoracic spine puncture and caudal advance of an epidural catheter for adequate analgesia in a patient with breast cancer with chest and upper back pain: A case report

Authors:
- Sanchun Ye
- Yubin Zhong
- Qingyan Yang
- Kewu Zheng
- Yuenong Zhang
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Affiliations: Department of Surgery and Anesthesia, The Third Affiliated Hospital of Sun Yat‑sen University, Yuedong Hospital, Meizhou, Guangdong 514700, P.R. China, Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat‑sen University, Yuedong Hospital, Meizhou, Guangdong 514700, P.R. China
Published online on: April 5, 2023 https://doi.org/10.3892/etm.2023.11937
Article Number: 238
Copyright: © Ye et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Patients with advanced cancer and metastasis frequently require analgesic treatments to relieve pain and maintain an acceptable quality of life. Continuous analgesic treatment with epidural drug infusion is one interventional approach to provide adequate pain relief. Most epidural analgesia procedures are performed with the catheter inserted in the lower thoracic or lumbar spine areas, which is then advanced in a cephalad direction to reach the level that requires analgesia. The present study reported on a patient with chest and upper back pain who failed oral oxycodone treatment. Epidural analgesia to target the T5 level was planned. However, a lower spinal puncture with cephalad advance of the catheter was not possible due to metastasis and compression in the T5‑8 levels. Thoracic spine puncture was performed between the T1 and T2 vertebrae and the infusion catheter was advanced in a caudal direction to reach the T5 level. Successful pain relief and amelioration of clinical symptoms demonstrated that the method may be considered a feasible and safe approach to achieve adequate analgesia and improve the quality of life of patients with similar conditions.

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