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American Journal of Hospice and Palliative Medicine®
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Video-Assisted Thoracoscopic Neurectomy of Intercostal Nerves in a Patient With Intractable Cancer Pain

Yu-Yung Lai, MD

Department of Anesthesilogy Buddhist Dalin Tzu Chi General Hospital, Taiwan, Republic of China; No.2. Min-Sheng Road, Dalin Town, Chia-Yi, Taiwan; YuhYeong_Lai{at}tzuchi.com.tw

Shi-Chi Chen, MD

Department of Family Medicine Buddhist Dalin Tzu Chi General Hospital, Taiwan, Republic of China

Nai-Chuan Chien, MD

Department of Thoracic Surgery Buddhist Dalin Tzu Chi General Hospital, Taiwan, Republic of China

Cancer-related pain is complicated and unbearable. Pain management techniques must be constantly modified and improved, with the goal of decreasing pain and enabling patients to withstand it. A 56-year-old man with colon cancer and multiple metastases was suffering from intense pain that was not relieved by extremely high doses of intravenous morphine. Temporary pain relief was achieved twice by blockade of the intercostal nerves with local anesthetics. Radiofrequency ablation was then performed under fluoroscopic monitoring; however, the procedure resulted in little pain relief. Finally, a neurectomy to cauterize the intercostal nerves was completed with video-assisted thoracoscopy under general anesthesia.

Key Words: ablative therapy • cancer • pain

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 6, 475-478 (2007)
DOI: 10.1177/1049909106294821
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