Combined spinal cord stimulation and intrathecal Morphine–Sufentanil therapy for refractory cancer pain: a case report

TL;DR

A patient with severe cancer pain found relief using a combination of spinal cord stimulation and intrathecal morphine-sufentanil therapy.

Contribution

This case report demonstrates a novel combination therapy for refractory cancer pain using spinal cord stimulation and intrathecal sufentanil.

Findings

Combination therapy significantly reduced pain and improved sleep quality in a patient with refractory cancer pain.

Spinal cord stimulation alone became ineffective due to tolerance development.

Intrathecal morphine and sufentanil provided effective analgesia when SCS failed.

Abstract

This case report describes the management of a 61-year-old female patient with metastatic adenoid cystic carcinoma and chronic refractory cancer pain. Initially treated with spinal cord stimulation (SCS), she later developed tolerance and inadequate analgesia. An intrathecal drug delivery system (IDDS) was subsequently implanted, and combination therapy with intrathecal morphine and sufentanil was initiated. This regimen achieved significant pain relief, reduced Numerical Rating Scale (NRS) scores, and improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). The case highlights the potential efficacy of combining neuromodulation and intrathecal analgesia in managing complex cancer pain. However, due to limited data on sufentanil use in IDDS and the absence of standardized conversion protocols, further studies are warranted.

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