Intrathecal Ziconotide for Malignant Pain in a Patient with Squamous Cell Carcinoma of the Oesophagus with Side Effects to Opioids: A Case Report

摘要

This case report describes the successful switch to intrathecal (IT) ziconotide in a patient with nociceptive pain related to bony metastases secondary to squamous cell carcinoma of the oesophagus. Although good analgesia had been achieved in this patient with oral opioids, pain relief was accompanied by excessive nausea and vomiting. In an attempt to alleviate the intolerable opioid-related side effects, an IT drug delivery (ITDD) device was implanted. As the IT opioids were found to be associated with a similar tolerability profile to the orally-administered drugs the patient was switched to IT ziconotide therapy. Nausea and vomiting cleared within 48 hours. Pain relief similar to that achieved with opioids but with minimal side effects was achieved with ziconotide during the final months of the patient's life.