CANCER PAIN MANAGEMENT: ROLE OF INTRATHECAL ALCOHOL: A CASE REPORT

A 34 year old lady was found to be in acute pain due to metastatic phaeochromocytoma following involvement of L5, S1 & S2 vertebrae. She was treated with series of MIBG scanning and ablation and surgical option was refused by the patient. She was suffering from rapidly increasing radicular pain of the lower limbs which was being managed with oral and injectable opioids. The team of doctors treating her decided to give epidural opioids and bupivacaine initially but the total dose of the drug and frequency was found to be gradually increased. Therefore, continous administration of intathecal opiods and bupivacaine was given but the same problem occured after a few weeks and pain relief was minimal. Ultimately intrathecal absolute alcohol was given as there were no more options left. The patient had dramatic pain relief till her death.