Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma

Abstract Background Anal and perineum pain caused by malignant tumor invasion is often difficult to control with opioids. Continuous sacral epidural ethanol injection therapy is less likely to cause bladder and rectal disturbances, making it a suitable treatment option for patients with preserved vo...

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Main Authors: Takehito Sato, Shigeru Inoue, Ichiko Asano, Takahiro Ando, Yasuyuki Shibata
Format: Article
Language:English
Published: SpringerOpen 2024-12-01
Series:JA Clinical Reports
Subjects:
Online Access:https://doi.org/10.1186/s40981-024-00760-x
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author Takehito Sato
Shigeru Inoue
Ichiko Asano
Takahiro Ando
Yasuyuki Shibata
author_facet Takehito Sato
Shigeru Inoue
Ichiko Asano
Takahiro Ando
Yasuyuki Shibata
author_sort Takehito Sato
collection DOAJ
description Abstract Background Anal and perineum pain caused by malignant tumor invasion is often difficult to control with opioids. Continuous sacral epidural ethanol injection therapy is less likely to cause bladder and rectal disturbances, making it a suitable treatment option for patients with preserved voiding function. Case presentation A 45-year-old woman with multiple metastases of malignant pheochromocytoma suffered severe anal pain that worsened, especially when sitting, and was unresponsive to opioid rescue therapy. With her NRS score of 9, a sacral epidural catheter was placed, and a continuous infusion of 2% lidocaine was administered overnight. This is followed by a 1.5mL bolus of ethanol and continuous ethanol administration at 2 mL/h. After administration, her anal pain decreased to approximately NRS 0–1, and she was subsequently discharged. Conclusion We report successful pain control using continuous sacral epidural ethanol injection therapy in a patient with anal pain due to malignant pheochromocytoma metastasis.
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spelling doaj-art-cf834674b6eb48dab29e02103bcf1d652025-08-20T02:39:52ZengSpringerOpenJA Clinical Reports2363-90242024-12-011011410.1186/s40981-024-00760-xSuccessful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytomaTakehito Sato0Shigeru Inoue1Ichiko Asano2Takahiro Ando3Yasuyuki Shibata4Department of Anesthesiology, Nagoya University HospitalDepartment of Anesthesiology, Nagoya University HospitalDepartment of Anesthesiology, Nagoya University HospitalDivision of Operation Room, Nagoya University HospitalDivision of Operation Room, Nagoya University HospitalAbstract Background Anal and perineum pain caused by malignant tumor invasion is often difficult to control with opioids. Continuous sacral epidural ethanol injection therapy is less likely to cause bladder and rectal disturbances, making it a suitable treatment option for patients with preserved voiding function. Case presentation A 45-year-old woman with multiple metastases of malignant pheochromocytoma suffered severe anal pain that worsened, especially when sitting, and was unresponsive to opioid rescue therapy. With her NRS score of 9, a sacral epidural catheter was placed, and a continuous infusion of 2% lidocaine was administered overnight. This is followed by a 1.5mL bolus of ethanol and continuous ethanol administration at 2 mL/h. After administration, her anal pain decreased to approximately NRS 0–1, and she was subsequently discharged. Conclusion We report successful pain control using continuous sacral epidural ethanol injection therapy in a patient with anal pain due to malignant pheochromocytoma metastasis.https://doi.org/10.1186/s40981-024-00760-xAnalgesic treatmentAnal painEthanol injection
spellingShingle Takehito Sato
Shigeru Inoue
Ichiko Asano
Takahiro Ando
Yasuyuki Shibata
Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
JA Clinical Reports
Analgesic treatment
Anal pain
Ethanol injection
title Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
title_full Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
title_fullStr Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
title_full_unstemmed Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
title_short Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
title_sort successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma
topic Analgesic treatment
Anal pain
Ethanol injection
url https://doi.org/10.1186/s40981-024-00760-x
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