Epidural for both anesthesia and analgesia in an oncology patient

An oncology patient requiring long-term surgical care and pain control had a lumbar epidural catheter placed for 7 days and reapplied for another 7 days. The catheter served two purposes: (1) for instillation of a regional anesthetic for daily vulvovaginal debridement procedures, and, (2) for instillation of morphine for extended analgesia. The minor surgical procedure was performed in the patient's bed at least once daily sparing the need and expense of general anesthesia and the operating room. The analgesic effect of the epidurally instilled morphine lasted up to 16 hr per average 8-mg dose. During this anodyne period, the patient was ambulatory, maintaining motor stability, yet not experiencing any perineal pain usually exacerbated by movement. No complications, including no infection as might be expected, were encountered with extended catheter placement. There was almost no need for additional oral or parenteral narcotics.