Uporaba lidokaina, ketamina in haloperidola v podkožni infuziji za zdravljenje nevropatske bolečine
Use of lidocaine, ketamine and haloperidol in a subcutaneous infusion for treatment of neuropathic pain

slovenian

2008

volume 77, issue 3

Chordoma   drug   Drug Therapy   Hordom   Ketamine   Lidocaine   Middle Age   Neuralgia   Spinal Neoplasms   therapy

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background Cancer patients can suffer because of severe, intractable neuropathic pain which cannot be relieved even by increasing the dose of opioid drugs. Patients treated with high doses of opioids can be drowsy and oversedated. They may have problems with nausea, dizziness and constipation. Neuropathic pain in cancer can be successfully treated with local anaesthetics, anticonvulsans, tricyclic antidepressants, antiepileptic drugs and NMDA receptor agonists. After introduction of these drugs in the pain treatment one can usually achieve successful pain relief, opioid dose can be reduced and its effectiveness increased. Methods In the case report a case of a patient with severe neuropathic pain, treated by high dose of opioid, is presented. Pain relief was achieved by subcutaneous infusion of lidocaine, to which, in the course of treatment, ketamine S and haloperidol were added. Opioid dose reduction was made possible. Conclusions Successful neuropathic pain relief can be achieved by subcutaneous infusion of lidocaine not only in cancer pain patients but other neuropathic pain syndromes. For a safe home treatment protocol the lowest possible dose of lidocaine should be used. To increase its effect, it can be combined with ketamin S and haloperidol.

16.09.2009