A case of neuropathic pain after spinal surgery successfully controlled by continuous brachial plexus block and rehabilitation and social support

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  • OKUNO Satoko
    Department of Anesthesiology and Palliative Care, Nissay Hospital
  • YAMASAKI Kyoko
    Department of Anesthesiology and Palliative Care, Nissay Hospital
  • HANADA Rumi
    Department of Anesthesiology and Palliative Care, Nissay Hospital
  • KAWAHARA Ryoko
    Department of Anesthesiology and Palliative Care, Nissay Hospital

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Other Title
  • 持続腕神経叢ブロックを契機とした多面的アプローチによりオピオイドを中止しえた頸椎椎弓形成術後慢性痛患者の1例
  • 症例 持続腕神経叢ブロックを契機とした多面的アプローチによりオピオイドを中止しえた頸椎椎弓形成術後慢性痛患者の1例
  • ショウレイ ジゾク ワン シンケイソウブロック オ ケイキ ト シタ タメンテキ アプローチ ニ ヨリ オピオイド オ チュウシ シエタ ケイツイシイキュウ ケイセイ ジュツゴ マンセイツウ カンジャ ノ 1レイ

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Opioids have been regarded as the most effective analgesics for treating cancer pain, whereas their administration is still controversial in chronic noncancer pain. We report a 73-year-old male with persistent cervical pain after cervical spine surgery. The administration of fentanyl patches of 6.3 mg and gabapentin of 1,200 mg failed to relieve the pain. His excruciation resulted in insomnia, depression, and body weight loss of 6 kg. A continuous brachial plexus block with 0.2% ropivacaine was conducted with the method known as patient-controlled analgesia (PCA); thus it proved the effectiveness of an ultrasound-guided brachial plexus block. With decreasing pain, the dosage of opioid administration was tapered without withdrawal phenomenon. Lastly, he could manage his cervical pain without opioid use. Moreover, rehabilitation and social support by medical social workers were virtually useful and helpful for the patient and his family.

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