Subcutaneous tunneled intrapleural catheters in the long-term relief of right upper quadrant pain of malignant origin

A 33-yr-old, 42-kg female, with extensive hepatic metastatic disease with intractable pain unresponsive to narcotic analgesics, nonsteroidal antiinflammatory drugs, and tricyclic antidepressants, is presented. Management of this patient's intractable pain with local anesthetics administered via a tunneled intrapleural catheter is discussed. Tunneling techniques are described. The patient continued to experience excellent pain relief at 6 wk follow-up.