A 6-year-old boy presented with a large, rapidly growing osteosarcoma of the upper humerus and severe neuropathic arm pain. Despite large doses of morphine (100 μg/kg/hr), which resulted in intermittent somnolence and respiratory depression, his pain was poorly controlled. An interscalene brachial plexus catheter was inserted, and bupivacaine was injected on ten occasions over 5 days, with markedly improved analgesia and decreased opioid requirement. Cancer pain in children can be controlled by opioids in 95 % of cases; however, circumstances such as intractable neuropathic pain may require specific regional anesthetic techniques. © 1994.
Cooper, M. G., Keneally, J. P., & Kinchington, D. (1994). Continuous brachial plexus neural blockade in a child with intractable cancer pain. Journal of Pain and Symptom Management, 9(4), 277–281. https://doi.org/10.1016/0885-3924(94)90106-6