Epidural Analgesia at End of Life: Facing Empirical Contraindications

Hans Juha Exner, Jürgen Peters, Matthias Eikermann

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1740-1742
Number of pages3
JournalAnesthesia and analgesia
Issue number6
StatePublished - Dec 2003
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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