TY - JOUR T1 - Sevoflurane topical analgesia for intractable pain with suicidal ideation JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care SP - e192 LP - e193 DO - 10.1136/bmjspcare-2019-002023 VL - 12 IS - e2 AU - F Dámaso Fernández-Ginés AU - Manuel Cortiñas-Sáenz AU - Carmen Selva-Sevilla AU - Manuel Gerónimo-Pardo Y1 - 2022/07/01 UR - http://spcare.bmj.com/content/12/e2/e192.abstract N2 - Proper symptom management to improve quality of dying is mandatory in palliative care patients. Home-based control of pain caused by leg ulcers is challenging, especially when the pain is severe and refractory to conventional analgesics, the patient is intolerant to opioids and refuses invasive measures. This was the case for an 87-year-old woman under oncological palliative care who suffered from a leg ulcer causing refractory pain, which produced suicidal ideation. Leg amputation was indicated, but she had signed a living will refusing any invasive measures. After obtaining written informed consent, sevoflurane was applied topically on the ulcer, which resulted in a rapid and long-lasting reduction of pain. Daily self-administration of sevoflurane successfully controlled the wound pain and the patient abandoned her suicidal ideation, the wound healed 35 days later, and her quality of dying improved remarkably. Topical sevoflurane deserves further research on ulcers of vascular and also neoplastic aetiology. ER -