End of mesothelioma story ?

On Friday the 16th of May we implanted an intrathecal pump system after the additional radiotherapy did not produced any alleviation of the patient's thoracic pain. The placement of the catheter was complicated by paresthesias when passing the region where the tumor infiltrated the spinal canal. This left the patient with neuropathic pain over the dorsum of the left foot which progressively disappeared over the next 24 hours. Today, three days after the intervention there are still some paresthesias in the same territory. 

We were able to place the catheter tip at T5 behind the spinal cord but unable to direct it over to the left side. The pump contains isobaric bupivacaine produced by our pharmacist, M. Golaz at "Pharmacie Internationale", at a concentration of 40 mg/ml and a pH of 6.5. No preservatives have been added. 

After purging the catheter this morning we have now started the pump with an initial rate of 4 mg/24 hours. The result is a bilateral sensory block from T5 to T8 and complete disappearance of pain as well as the sympathetic component in the form of sweating in the pain-full territory described in our first report from March 12. The orthostatic function is well maintained.