Procedures of Locoregional Analgesia and Quality of Life in Palliative Care
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
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.
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Change in patients global quality of life
To evaluate the change in patients global quality of life, assessed by the item 15 of the validated quality of life scale EORTC QLQ-C15 PAL. Evaluations will take place before the procedure of locoregional analgesia and 1 week after.
1 week after first injection
Gérard TERRIER, MD
France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)