Tuberc Respir Dis > Volume 68(5); 2010 > Article
Tuberculosis and Respiratory Diseases 2010;68(5):286-289.
DOI: https://doi.org/10.4046/trd.2010.68.5.286    Published online May 1, 2010.
A Case of Successful Management of Lung Cancer Pain Using Ultrahigh-dose Fentanyl Patch.
Soo Ok Kim, Min Jee Kim, Yong Soo Kwon, Sung Chul Lim, Hee Jung Ban, In Jae Oh, Kyu Sik Kim, Young Chul Kim
1Department of Internal Medicine, Seonam University Medical School, Gwangju, Korea.
2Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. droij@chonnam.ac.kr
3Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Abstract
A 55-year old woman with advanced stage non-small cell lung cancer was admitted to hospital for the management of severe chest pain, which measured 7 out of 10 on a numerical rating scale (NRS). Despite palliative radiation and the application of multiple epidural blocks, she continued to experience severe cancer pain. We gradually increased the dose of transdermal fentanyl patches from 500 microgram/hr to 3,650 microgram/hr, for 3 months without any significant side effects. Concomitantly, adjuvant therapy with antidepressants and anticonvulsants were added, decreasing the patient's pain to NRS 3~4 down from 7. After being transferred to a hospice clinic, her chest pain was well-controlled below NRS 4 by means of strong opioid medications, including the highest dose of transdermal fentanyl 4,050 microgram/hr for more than 16 months.
Key Words: Lung Neoplasms, Chest Pain, Analgesics, Opioid


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