Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain: Technical case report

Michael Y. Wang, George P. Teitelbaum, William J. Loskota, Debra Eng, Felipe Albuquerque, J. Peter Gruen

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE AND IMPORTANCE: Infiltration of the brachial plexus with anesthetics can provide relief of upper-extremity pain from invasive cancer. Because the analgesia is short-lived, however, repeated invasive treatments are necessary. We describe the implantation of a catheter reservoir system, in which anesthetic injections through a subcutaneous port resulted in anesthetic infiltration of the brachial plexus. CLINICAL PRESENTATION: A 47- year-old Hispanic man with squamous cell carcinoma of the larynx had undergone surgical resection, radiation treatment, and chemotherapy. Two years later, he had locally recurrent disease involving the brachial plexus, neck, and chest wall. The patient's pain was minimally responsive to narcotics, which also caused severe nausea and anorexia. TECHNIQUE: The brachial plexus was localized percutaneously with a needle electrode stimulator. Contrast injection under fluoroscopy confirmed entry into the plexus sheath. With use of the Seldinger technique, two Silastic catheters were placed within the brachial plexus and attached with a 'Y' connector to a reservoir. The patient experienced complete relief of upperextremity pain after a test injection with xylocaine. Thereafter, serial injections of bupivacaine with triamcinolone at 1-week intervals provided complete pain relief. After the treatments were initiated, the patient reported improved sleep and an improvement in his quality of life. CONCLUSION: A catheter reservoir system for brachial plexus analgesia can provide safe and effective analgesia for upper-extremity pain. This technique negates the need for repeated invasive procedures and avoids the complications of neurolysis.

Original languageEnglish
Pages (from-to)1009-1012
Number of pages4
JournalNeurosurgery
Volume46
Issue number4
StatePublished - Apr 1 2000
Externally publishedYes

Fingerprint

Brachial Plexus
Upper Extremity
Catheters
Analgesia
Anesthetics
Pain
Injections
Brachial Plexus Neuropathies
Therapeutics
Triamcinolone
Fluoroscopy
Bupivacaine
Narcotics
Anorexia
Thoracic Wall
Larynx
Lidocaine
Hispanic Americans
Nausea
Needles

Keywords

  • Brachial plexus
  • Cancer pain
  • Head and neck cancer

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Wang, M. Y., Teitelbaum, G. P., Loskota, W. J., Eng, D., Albuquerque, F., & Gruen, J. P. (2000). Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain: Technical case report. Neurosurgery, 46(4), 1009-1012.

Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain : Technical case report. / Wang, Michael Y.; Teitelbaum, George P.; Loskota, William J.; Eng, Debra; Albuquerque, Felipe; Gruen, J. Peter.

In: Neurosurgery, Vol. 46, No. 4, 01.04.2000, p. 1009-1012.

Research output: Contribution to journalArticle

Wang, MY, Teitelbaum, GP, Loskota, WJ, Eng, D, Albuquerque, F & Gruen, JP 2000, 'Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain: Technical case report', Neurosurgery, vol. 46, no. 4, pp. 1009-1012.
Wang MY, Teitelbaum GP, Loskota WJ, Eng D, Albuquerque F, Gruen JP. Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain: Technical case report. Neurosurgery. 2000 Apr 1;46(4):1009-1012.
Wang, Michael Y. ; Teitelbaum, George P. ; Loskota, William J. ; Eng, Debra ; Albuquerque, Felipe ; Gruen, J. Peter. / Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain : Technical case report. In: Neurosurgery. 2000 ; Vol. 46, No. 4. pp. 1009-1012.
@article{94675739f9c34c938b6ea44b4d3abfae,
title = "Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain: Technical case report",
abstract = "OBJECTIVE AND IMPORTANCE: Infiltration of the brachial plexus with anesthetics can provide relief of upper-extremity pain from invasive cancer. Because the analgesia is short-lived, however, repeated invasive treatments are necessary. We describe the implantation of a catheter reservoir system, in which anesthetic injections through a subcutaneous port resulted in anesthetic infiltration of the brachial plexus. CLINICAL PRESENTATION: A 47- year-old Hispanic man with squamous cell carcinoma of the larynx had undergone surgical resection, radiation treatment, and chemotherapy. Two years later, he had locally recurrent disease involving the brachial plexus, neck, and chest wall. The patient's pain was minimally responsive to narcotics, which also caused severe nausea and anorexia. TECHNIQUE: The brachial plexus was localized percutaneously with a needle electrode stimulator. Contrast injection under fluoroscopy confirmed entry into the plexus sheath. With use of the Seldinger technique, two Silastic catheters were placed within the brachial plexus and attached with a 'Y' connector to a reservoir. The patient experienced complete relief of upperextremity pain after a test injection with xylocaine. Thereafter, serial injections of bupivacaine with triamcinolone at 1-week intervals provided complete pain relief. After the treatments were initiated, the patient reported improved sleep and an improvement in his quality of life. CONCLUSION: A catheter reservoir system for brachial plexus analgesia can provide safe and effective analgesia for upper-extremity pain. This technique negates the need for repeated invasive procedures and avoids the complications of neurolysis.",
keywords = "Brachial plexus, Cancer pain, Head and neck cancer",
author = "Wang, {Michael Y.} and Teitelbaum, {George P.} and Loskota, {William J.} and Debra Eng and Felipe Albuquerque and Gruen, {J. Peter}",
year = "2000",
month = "4",
day = "1",
language = "English",
volume = "46",
pages = "1009--1012",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain

T2 - Technical case report

AU - Wang, Michael Y.

AU - Teitelbaum, George P.

AU - Loskota, William J.

AU - Eng, Debra

AU - Albuquerque, Felipe

AU - Gruen, J. Peter

PY - 2000/4/1

Y1 - 2000/4/1

N2 - OBJECTIVE AND IMPORTANCE: Infiltration of the brachial plexus with anesthetics can provide relief of upper-extremity pain from invasive cancer. Because the analgesia is short-lived, however, repeated invasive treatments are necessary. We describe the implantation of a catheter reservoir system, in which anesthetic injections through a subcutaneous port resulted in anesthetic infiltration of the brachial plexus. CLINICAL PRESENTATION: A 47- year-old Hispanic man with squamous cell carcinoma of the larynx had undergone surgical resection, radiation treatment, and chemotherapy. Two years later, he had locally recurrent disease involving the brachial plexus, neck, and chest wall. The patient's pain was minimally responsive to narcotics, which also caused severe nausea and anorexia. TECHNIQUE: The brachial plexus was localized percutaneously with a needle electrode stimulator. Contrast injection under fluoroscopy confirmed entry into the plexus sheath. With use of the Seldinger technique, two Silastic catheters were placed within the brachial plexus and attached with a 'Y' connector to a reservoir. The patient experienced complete relief of upperextremity pain after a test injection with xylocaine. Thereafter, serial injections of bupivacaine with triamcinolone at 1-week intervals provided complete pain relief. After the treatments were initiated, the patient reported improved sleep and an improvement in his quality of life. CONCLUSION: A catheter reservoir system for brachial plexus analgesia can provide safe and effective analgesia for upper-extremity pain. This technique negates the need for repeated invasive procedures and avoids the complications of neurolysis.

AB - OBJECTIVE AND IMPORTANCE: Infiltration of the brachial plexus with anesthetics can provide relief of upper-extremity pain from invasive cancer. Because the analgesia is short-lived, however, repeated invasive treatments are necessary. We describe the implantation of a catheter reservoir system, in which anesthetic injections through a subcutaneous port resulted in anesthetic infiltration of the brachial plexus. CLINICAL PRESENTATION: A 47- year-old Hispanic man with squamous cell carcinoma of the larynx had undergone surgical resection, radiation treatment, and chemotherapy. Two years later, he had locally recurrent disease involving the brachial plexus, neck, and chest wall. The patient's pain was minimally responsive to narcotics, which also caused severe nausea and anorexia. TECHNIQUE: The brachial plexus was localized percutaneously with a needle electrode stimulator. Contrast injection under fluoroscopy confirmed entry into the plexus sheath. With use of the Seldinger technique, two Silastic catheters were placed within the brachial plexus and attached with a 'Y' connector to a reservoir. The patient experienced complete relief of upperextremity pain after a test injection with xylocaine. Thereafter, serial injections of bupivacaine with triamcinolone at 1-week intervals provided complete pain relief. After the treatments were initiated, the patient reported improved sleep and an improvement in his quality of life. CONCLUSION: A catheter reservoir system for brachial plexus analgesia can provide safe and effective analgesia for upper-extremity pain. This technique negates the need for repeated invasive procedures and avoids the complications of neurolysis.

KW - Brachial plexus

KW - Cancer pain

KW - Head and neck cancer

UR - http://www.scopus.com/inward/record.url?scp=0034129089&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034129089&partnerID=8YFLogxK

M3 - Article

C2 - 10764282

AN - SCOPUS:0034129089

VL - 46

SP - 1009

EP - 1012

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 4

ER -