Thoracic epidural analgesia to control malignant pain until viability in a pregnant patient

Jaideep H. Mehta, Mary Elizabeth Gibson, David Amaro-Driedger, Mahammad N. Hussain

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Management of nonobstetric pain in the pregnant patient presents unique challenges related to transplacental fetal exposure to opioids and the subsequent risk of neonatal withdrawal syndrome. We present the case of a pregnant patient suffering from the pain of a progressively enlarging thoracoabdominal sarcoma. Epidural analgesia (using local anesthetics with minimal opioid) was utilized over a span of weeks to manage oncologic pain, limiting fetal opioid exposure and culminating in the birth of a healthy infant. While nonobstetric abdominal pain during pregnancy is not that uncommon, neoplastic abdominal pain does appear to be rare. Combined local anesthetic and opioid continuous epidural infusion should be considered a viable option in the pain management approach to obstetric patients with nonobstetric pain associated with malignancy.

Original languageEnglish (US)
Pages (from-to)357-360
Number of pages4
JournalJournal of Pain Research
Volume9
DOIs
StatePublished - Jun 13 2016
Externally publishedYes

Keywords

  • Epidural
  • Malignant
  • Pregnancy
  • Sarcoma

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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