skip to main content

Ultrasound-Guided Supraorbital Nerve Block For Orbital Chronic Cancer Pain - A Case Report

1Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Diponegoro University/Kariadi General Hospital, Semarang, Indonesia

2Diponegoro University/Kariadi General Hospital, Semarang, Indonesia

Received: 21 Feb 2024; Published: 31 Mar 2024.

Citation Format:
Cover Image

Background: Many individuals with cancer suffer from pain symptom, typically ranging from moderate to severe levels. Multimodal approach has been used widely to manage the cancer pain. The ultrasound-guided peripheral nerve block has increasingly been used in the interventional pain management of chronic pain cases.

Case: A 54-year- old woman with metastatic breat cancer with osteolityc skull lesions complaining severe pain in periorbital area of left eye. Traditional systemic pain relief treatments were not successful in adequately reducing the pain. Ultrasound-guided supraorbital nerve block using ropivacaine 0.375% and methylprednisolone 125mg combination was successfully performed to reduce pain score of patient.

Discussion: Interventional methods aimed at managing cancer-related pain can function as successful treatment approaches for individuals who do not respond to or cannot tolerate systemic opioids. Peripheral nerve block is a technique which has been developed to help in relieving chronic case. When administered in conjunction with other therapies such as systemic analgesics, radiotherapy, and chemotherapy, the use of peripheral nerve blocks may provide valuable relief for a specific aspect of a patient's overall pain condition and improve quality of life.

Conclusion: Peripheral nerve blocks appear to be a safe option and may offer substantial pain relief, reducing the reliance on opioids in individuals with advanced cancer.

Fulltext View|Download
Keywords: cancer pain; chronic pain; ophthalmic block; peripheral nerve block; ultrasound-guided

Article Metrics:

  1. Deandrea S, Montanari M, Moja L, Apolone G. Prevalence of undertreatment in cancer pain. A review of published literature. Ann Oncol. 2008 Dec;19(12):1985–91
  2. Mercadante S. The Patient with Difficult Cancer Pain. Cancers. 2019 Apr;11(4):565
  3. Shute C. The Challenges of Cancer Pain Assessment and Management. Ulster Med J. 2013 Jan;82(1):40–2
  4. Mestdagh F, Steyaert A, Lavand’homme P. Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques. Curr Oncol. 2023 Jul 18;30(7):6838–58
  5. Amaram-Davila J, Davis M, Reddy A. Opioids and Cancer Mortality. Curr Treat Options Oncol. 2020 Feb 20;21(3):22
  6. Wiffen PJ, Wee B, Derry S, Bell RF, Moore RA. Opioids for cancer pain ‐ an overview of Cochrane reviews. Cochrane Database Syst Rev. 2017 Jul 6;2017(7):CD012592
  7. Pich J. The Analgesic Efficacy of Opioids in Cancer Pain. AJN The American Journal of Nursing. 2018 Dec;118(12):22
  8. Corli O, Floriani I, Roberto A, Montanari M, Galli F, Greco MT, et al. Are strong opioids equally effective and safe in the treatment of chronic cancer pain? A multicenter randomized phase IV “real life” trial on the variability of response to opioids. Ann Oncol. 2016 Jun;27(6):1107–15
  9. Napier A, De Jesus O, Taylor A. Supraorbital Nerve Block. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Feb 15]. Available from:
  10. Khor KE, Ditton JN. Femoral nerve blockade in the multidisciplinary management of intractable localized pain due to metastatic tumor: a case report. J Pain Symptom Manage. 1996 Jan;11(1):57–56
  11. Neill RS. Ablation of the brachial plexus. Control of intractable pain, due to a pathological fracture of the humerus. Anaesthesia. 1979;34(10):1024–7
  12. Mercadante S, Sapio M, Villari P. Suprascapular nerve block by catheter for breakthrough shoulder cancer pain. Reg Anesth. 1995;20(4):343–6
  13. Taylor A, McLeod G. Basic pharmacology of local anaesthetics. BJA Education. 2020 Feb 1;20(2):34–41
  14. Fozzard HA, Lee PJ, Lipkind GM. Mechanism of local anesthetic drug action on voltage-gated sodium channels. Curr Pharm Des. 2005;11(21):2671–86
  15. Becker DE, Reed KL. Local Anesthetics: Review of Pharmacological Considerations. Anesth Prog. 2012;59(2):90–102
  16. Krishna Prasad GV, Khanna S, Jaishree SV. Review of adjuvants to local anesthetics in peripheral nerve blocks: Current and future trends. Saudi J Anaesth. 2020;14(1):77–84
  17. Leppert W, Buss T. The Role of Corticosteroids in the Treatment of Pain in Cancer Patients. Curr Pain Headache Rep. 2012;16(4):307–13
  18. Manchikanti L. Role of neuraxial steroids in interventional pain management. Pain Physician. 2002 Apr;5(2):182–99
  19. Eker HE, Cok OY, Aribogan A, Arslan G. Management of Neuropathic Pain with Methylprednisolone at the Site of Nerve Injury. Pain Med. 2012 Mar;13(3):443–51

Last update:

No citation recorded.

Last update: 2024-06-15 01:16:54

No citation recorded.