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Peripheral nerve blocks in advanced cancer pain: retrospective case series
  1. Erika Anna Sofia Rouhento1,
  2. Juho T Lehto1,2 and
  3. Maija-Liisa Kalliomäki1,3
  1. 1 Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
  2. 2 Palliative Care Centre and Tays Cancer Centre, Department of Oncology, Tampere University Hospital, Tampere, Finland
  3. 3 Department of Anaesthesia, Tampere University Hospital, Tampere, Finland
  1. Correspondence to Dr Maija-Liisa Kalliomäki, Tampere University, Tampere 33521, Finland; maija-liisa.kalliomaki{at}pshp.fi

Abstract

Objectives Patients with cancer often suffer severe pain that is not relieved with systemic analgesics and requires further treatment options. This study aims to investigate whether peripheral nerve blocks are a feasible treatment option in patients with incurable cancer who suffer from severe pain.

Methods All patients with advanced cancer who received a peripheral nerve block for the management of pain at the Tampere University Hospital between January 2015 and December 2018 were included in this retrospective study. The characteristics of the patients’ features of the nerve blocks, opioid dosing (daily morphine equivalent) before and after the blocks, and patient-reported pain relief following peripheral block were assessed from the medical records.

Results Sixteen of the 17 patients included in this study received pain relief through a nerve block. Daily opioid dose was decreased with the block in 12 (71%) patients with a median change in daily morphine equivalent of −20 mg (IQR: −180 to 9). One infection of the catheter and two other transient adverse events occurred, but none was serious or fatal.

Conclusions Peripheral nerve blocks seem safe and may provide considerable analgesia and decrease the need for opioids in patients with advanced cancer.

  • cancer
  • pain

https://doi.org/10.1136/bmjspcare-2021-003293

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    Footnotes

    • Contributors EASR has gathered all the data under supervision of JTL and M-LK. EASR provided the initial version of the manuscript and preliminary analysis of the results. These were then worked on together with JTL and M-LK. Thus, all authors fulfil the following requirements: (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; (3) final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Author note Research reporting guideline: CARE guideline used for case series reporting was considered most suitable and used for checklisting. However, many of the items in the list list did not apply to our study presenting a series of patients with the main aim at relieving pain.