The use of patient-controlled boluses of local anaesthetic via a psoas sheath catheter in the management of malignant pain

Patients who develop malignant infiltration of the psoas muscle and the lum bar plexus often experience a severe complex pain syndrome characterised by deep somatic pain, neuropathic pain and psoas spasm. Conventional analgesi c regimes may not relieve these symptoms adequately. We describe the use of patient-controlled boluses of local anaesthetic via a psoas sheath cathete r in this scenario. The recent availability of portable infusion pumps with the capability to deliver large volume boluses with long lockout times mad e this intervention possible and allowed the patient to be discharged home with effective relief of pain. (C) 1999 International Association for the S tudy of Pain. Published by Elsevier Science B.V.