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Case report
Interpedicular approach in percutaneous sacroplasty for treating pain due to direct invasion of rectal cancer into the S3 body: a case report
Jinseok Yeo, Saeyoung Kim, Chang Sub Lee
Received November 14, 2023  Accepted January 7, 2024  Published online February 20, 2024  
DOI: https://doi.org/10.7180/kmj.23.153    [Epub ahead of print]
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Abstract PDFPubReader   ePub   
Percutaneous sacroplasty is mainly used as an intervention for pain associated with sacral insufficiency fractures or sacral metastatic tumors. However, sacroplasty for managing the pain associated with direct sacral invasion of rectal cancer has been rarely reported. We present a case of a 74-year-old patient who underwent sacroplasty via the interpedicular approach under fluoroscopic guidance to relieve pain resulting from direct tumor invasion into the S3 body. After the procedure, the patient experienced immediate pain relief and did not feel worse pain with ambulation. Aside from peritumoral vascular leakage, no other significant complications occurred immediately post-procedure. Our results suggest that fluoroscopically guided interpedicular sacroplasty is a safe and effective option for relieving the pain associated with direct sacral invasion by rectal cancer.
Original article
The effects of ketamine on pain control in stage IV cancer patients receiving palliative care
Seonghoon Kim, Jihun Kang, Jongsoon Choi, Eunhee Kong
Kosin Med J. 2022;37(1):37-45.   Published online March 14, 2022
DOI: https://doi.org/10.7180/kmj.21.003
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Abstract PDFPubReader   ePub   
Background
We evaluated the effects of intravenous ketamine on cancer pain in stage IV cancer patients receiving palliative care.
Methods
In total, 253 stage IV cancer patients with cancer pain hospitalized at a single tertiary hospital palliative care unit were included. The ketamine group contained 112 patients receiving ketamine, and the control group comprised 141 non-ketamine users. To evaluate the odds ratios (ORs) for favorable pain control, optimal pain control, and opioid-sparing effect among ketamine users, we used multivariable logistic regression adjusted for age and objective prognosis score. Differences in the visual analog scale (VAS) score, oral morphine equivalents, inter-dose frequency, and inter-dose amount were compared between both groups at the time of ketamine introduction (T0), after 24 hours (T1), and after 48 hours (T2) using repeated-measures analysis of covariance.
Results
The ketamine group was more likely to show favorable pain control (OR, 3.84; 95% confidence interval [CI], 1.76–8.37) and an optimal response (OR, 3.99; 95% CI, 1.73–9.22) than the control group. Compared to the control group, the ketamine group showed a higher VAS score at T0, but a more evident VAS score reduction at T1 and T2 (pint<0.001). The ketamine group was less likely than the control group to experience depressive mood (OR, 0.31; 95% CI, 0.10–0.92), but had a higher risk of delirium (OR, 2.06; 95% CI, 1.12–3.91).
Conclusion
Our findings suggest that ketamine can effectively reduce refractory cancer pain in stage IV cancer patients.

Citations

Citations to this article as recorded by  
  • Prevalence of Pain and Factors Affecting it in Patients with Lung Cancer in Ilam
    Elham Bastani, Mahsa Rizehbandi, Fariba Shokri
    International Journal of Cancer Management.2024;[Epub]     CrossRef
  • Is ketamine useful for pain management in patients with stage IV cancer?
    Sung Eun Kim
    Kosin Medical Journal.2022; 37(1): 1.     CrossRef
Review article
Psychiatric Aspects of Cancer Pain
Ho Chan Kim
Kosin Med J. 2009;24(1):7-13.   Published online June 30, 2009
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KMJ : Kosin Medical Journal