Corticosteroid Injections for Knee Pain at the End of Life.
Corticosteroid Injections for Knee Pain at the End of Life.
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注射皮质类固醇治疗临终时的膝盖疼痛。
DOI：
10.1089/jpm.2015.0095
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发表时间：
2015
影响因子：
2.8
通讯作者：
Bruera,Eduardo
中科院分区：
文献类型：
--
作者：
Fu,JackB;Dhah,SatinderpalS;Bruera,Eduardo
编辑先生：癌症患者通常会接受局部止痛注射。1关节内注射治疗临终疼痛以前没有报道。我们报告一例无法治愈的进行性脑膜瘤患者，在生命末期伴有严重的双侧膝关节疼痛。我们的患者是一名60岁出头的女性，她曾多次治疗左侧矢状面旁脑膜瘤，但均未成功。她患有痉挛偏瘫和药物控制的癫痫发作。在膝关节注射前8天，她在疼痛管理预约中有明显的双侧膝关节疼痛，归因于骨关节炎。计划在几周后进行双侧膝关节皮质类固醇注射。她在注射前三天在神经肿瘤科诊所就诊。她决定参加家庭临终关怀。患者退出物理治疗(PT)。那天我们通过电话联系了她，她说她想尝试双侧膝盖注射，但计划在几周后进行。我们讨论了她需要尽快注射，因为她在临终关怀期间可能无法接受这些注射。考虑到严重的症状负担，计划进入临终关怀计划，而且因为我们可以更快地容纳她，我们安排她在三天后在康复诊所注射。在超声引导下双膝关节内注射皮质类固醇。埃德蒙顿酒店
Dear Editor: Localized pain injections are commonly performed on cancer patients. 1 Intra-articular joint injections for end-of-life pain has not been reported previously. We present a case of a patient with untreatable progressive meningioma with severe bilateral knee pain at the end of life. Our patient is a female in her early 60s who had failed multiple treatments for a left parasagittal meningioma. She suffered from spastic hemiplegia and medicationcontrolled seizures. She had significant bilateral knee pain that was attributed to osteoarthritis at a pain management appointment eight days prior to the knee injection. A bilateral knee corticosteroid injection was scheduled several weeks later.She was seen in the neuro-oncology clinic three days prior to injection. It was decided that she would enroll in home hospice care. The patient withdrew from physical therapy (PT). We contacted her by phone that day and she stated that she would like to try the bilateral knee injections but that they were scheduled for several weeks later. We discussed that she needed the injections as soon as possible because she could be unable to receive these injections while under hospice care. Given the significant symptom burden, plans for eminent enrollment in hospice program, and because we could accommodate her sooner, we scheduled her for injection in the rehabilitation clinic three days later. Intra-articular ultrasound guided corticosteroid injections to the bilateral knees were performed. The Edmonton