Patient-controlled analgesia for treatment of intractable pain at home

Abstract

A 66-year-old male had been operated on for pancreatic carcinoma 3 months before being referred to our department for relief of intractable pain. A continuous infusion of fentanyl 1 mg and bupivacaine 0.5 per cent 200 mg diluted in saline 120 ml was begun at a rate of 6 ml/h through a subcutaneously fixed epidural catheter which had been inserted at the L1-L2 intervertebral space. The infusion pump was programmed for home therapy, Changing of the bag of solutions and filters was done by the patient's relatives. The analgesia was provided with one and the same catheter throughout and he continued normal daily activity until death 113 days after start of the infusion. No adverse drug effect or infection were observed during this period. In conclusion, we believe that patient-controlled analgesia at home is a valuable method for pain relief of cancer patients, especially in the terminal stages.