TY - JOUR
T1 - Epidural Analgesia at End of Life
T2 - Facing Empirical Contraindications
AU - Exner, Hans Juha
AU - Peters, Jürgen
AU - Eikermann, Matthias
PY - 2003/12
Y1 - 2003/12
N2 - In a patient with unbearable cancer pain at the end of life, long-lasting analgesia without impairment of consciousness could only be achieved with an epidural infusion of local anesthetics combined with opioids and clonidine. Despite leptomeningeal infection during prolonged treatment, epidural analgesia at the lumbar level provided analgesia using very large doses of local anesthetics combined with clonidine and morphine. Thus, terminal sedation was avoided, allowing the patient's end-of-life planning of an "aware" death surrounded by her family. It may be useful to reconsider institutional pain management standards when unbearable pain occurs in patients with limited life expectancy.
AB - In a patient with unbearable cancer pain at the end of life, long-lasting analgesia without impairment of consciousness could only be achieved with an epidural infusion of local anesthetics combined with opioids and clonidine. Despite leptomeningeal infection during prolonged treatment, epidural analgesia at the lumbar level provided analgesia using very large doses of local anesthetics combined with clonidine and morphine. Thus, terminal sedation was avoided, allowing the patient's end-of-life planning of an "aware" death surrounded by her family. It may be useful to reconsider institutional pain management standards when unbearable pain occurs in patients with limited life expectancy.
UR - http://www.scopus.com/inward/record.url?scp=0344851900&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0344851900&partnerID=8YFLogxK
U2 - 10.1213/01.ANE.0000086725.01761.8B
DO - 10.1213/01.ANE.0000086725.01761.8B
M3 - Article
C2 - 14633552
AN - SCOPUS:0344851900
SN - 0003-2999
VL - 97
SP - 1740
EP - 1742
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 6
ER -
