A case report of sustained resolution of cancer pain by continuous perineural infusion of local anesthetic

Summary

We report the case of a patient with a shoulder desmoid tumor for which monitoring of tumor progression was the sole therapeutic strategy. Analgesia took the form of patient-controlled infusion of local anesthetics through an interscalene catheter. Due to the need of an MRI control 45 days later, the pump was stopped. The persistence of pain relief 48 hours later led to the decision to remove the perineural catheter. No pain was reported by the patient over the following 42 days. In this patient, it would seem that continuous analgesia allowed for a sustained resolution of pain from the shoulder-located tumor. One hypothesis is that local anesthetics play a direct role in the erasure of pain memory. This hypothesis needs to be tested with a large patient cohort.