Peripheral Nerve Blocks in Palliative Care for Cancer Patients

Abstract

Despite rapid developments in oncology, cancer patients often suffer pain. Pain in cancer is not one single entity and does not respond to one drug. Although opioid consumption is rapidly increasing, many kinds of cancer pain do not respond to it. A more differentiated diagnosis and treatment is necessary. Nerve compression pains tend to be a serious and undervalued problem, and they respond slightly or not at all to standard analgesics. This chapter presents the most recent views on the etiology of nerve compression in cancer and describes several nerve compression syndromes that can be easily treated, at the bedside, with injection of local anesthetics and corticosteroids. Interestingly, most of these syndromes were described decades ago but neglected in the era of modern imaging techniques, as most of the small cutaneous nerves remain invisible. The nerve compression syndromes are different from those observed in the general population. Most of the compressed nerves are located on the rear side of the body, which suggests that long-lasting stays in bed in the recumbent position are an important factor.