PATIENT-CONTROLLED ANALGESIA USING ROPIVACAINE VIA AN INTRATHECAL CATHETER

Background and Objectives. A 38-year-old woman presented with severe i ntractable pain in the sacral and perirectal areas secondary to metast atic stage I.B. squamous cell carcinoma of the cervix. Methods. An ind welling epidural catheter was placed to control the patient's symptoms after failure of conservative therapies. Finally, an infusion contain ing isobaric 0.2% ropivacaine with 0.002% preservative-free morphine a nd 0.0002% epinephrine was started to treat her pain and preserve moto r function to preserve quality of life. Results. The patient obtained good pain relief with this regimen and was discharged home. She was ab le to walk with assistance and maintain good quality of life until her death approximately 7 weeks after the placement of the indwelling epi dural catheter. Conclusion. The use of ropivacaine in combination with other analgesics, via an intrathecal catheter for patient-controlled analgesia, was an effective treatment for this patient. In the future, ropivacaine administered epidurally or intrathecally alone, or in com bination with other analgesics, may become the local anesthetic of cho ice due to its preservation of motor function. Certainly, further scie ntific studies are indicated in the cancer patient population.