Continuous intra-articular patient-controlled analgesia in a cancer patient with a pathological hip fracture a case report

S. Shabat, A. Stern, Y. Kollender, M. Nyska

Research output: Contribution to journalArticlepeer-review

Abstract

Pain management is one of the major goals to achieve in treating terminal patients. Managing severe pain with drug therapy by using a combination of narcotics, non-narcotics, and adjuvant drugs provides the best results for most patients. In patients with fractures due to bone metastases there is a relative indication for operative treatment if the patient is expected to survive the operation and to recover in the postoperative period. In this case report a terminal 48 year-old female with a pathological femoral neck fracture is presented. No operative treatment was offered because of her bad general status. Pain control was maintained by continuous administration of local analgesics directly into the intra-articular femoral space, through a system of patient-controlled analgesia (PCA). The visual-analogue pain scale (VAS), which was maximal before beginning of this treatment, was markedly reduced during the treatment, and was again elevated to maximum after the intra-articular catheter was removed. Although continuous regional analgesia to a fractured bone which involves the joint is not a generally acceptable method and carries some risks it has a role in a selected group of patients.

Original languageEnglish
Pages (from-to)304-306
Number of pages3
JournalActa Orthopaedica Belgica
Volume67
Issue number3
StatePublished - 2001
Externally publishedYes

Keywords

  • Analgesia
  • Femoral neck
  • Fracture
  • Metastasis

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