Procedures of Locoregional Analgesia and Quality of Life in Palliative Care Units
Procedures of Locoregional Analgesia and Quality of Life in Palliative Care Units
Number of patients in mobile palliative care units have pain of both nociceptive and
 neuropathic origin. In certain cases, procedures of locoregional analgesia can be helpful.

 The Purpose of this study is to evaluate the impact of techniques of locoregional analgesia
 in a palliative population
Cancer pain is a serious problem in the palliative population. In particular, pain due to
 compression or invasion of nerve tissue by metastasis is frequent and often unresponsive to
 oral drug therapy and even to epidural administration of opioids. In such refractory pain in
 a palliative setting, one modality that could be helpful is the use of technics of
 locoregional analgesia. Currently, they are routinely used for the management of acute
 postoperative pain and become to be more widely used for cancer surgery. For example,
 intrapleural intercostal nerve blocks after major lung resection or preincisional
 paravertebral blocks after breast surgery have been shown to improve pain control. However,
 locoregional analgesia is only occasionally used in chronic cancer pain.

 The procedures used are epidural analgesia, rachianesthesia, or continuous nerve blocks.
 L-bupivacaine will be used. The procedure will be performed only if the injection test is
 positive.

 The patients will be evaluated before and after the procedure, the patient being his/her own
 control. Evaluations will take place immediately before the procedure, then at 48 hours, 1
 week and 1 month after the procedure.
Inclusion Criteria:

 -  Patient ≥ 18 years-old, male or female, whatever his/her ethnic group

 -  Patient with untreatable cancer

 -  Patient hospitalized in a palliative care unit, with a life expectancy ≥ 1 week

 -  Pain unresponsive to conventional treatments

 -  Effectiveness of the injection test

 -  Signed informed consent

 Exclusion Criteria:

 -  Patients > 18 years-old

 -  Patients with pain other than cancer pain

 -  Patient's refusal

 -  Coagulation disorders

 -  Local infection

 -  Known hypersensitivity to local analgesics

 -  Inefficacy of the injection test.

 -  Contraindication for analgesics