Use of propofol for painful procedures in cancer pain management

Background: Patients with intractable cancer pain often require non-pharmacological analgesic treatment that is accompanied by procedure-related pain. Previous works have shown that propofol infusion in adjunction to regional anesthesia provides appropriate sedation during such painful procedures. However, there are a few reports of its use to reduce procedure-related pain in terminal cancer patients. We report cases of propofol sedation during percutaneous vertebroplasty (PVP) in patients with metastatic vertebral compression fracture. Methods: Propofol was infused during PVP in eleven cancer patients after obtaining written informed consent. The infusion rate of propofol was adjusted using a target-controlled infusion pump to achieve appropriate sedation levels under monitoring bispectral index of the electroencepharogram. Hepatic and renal functions were evaluated using common serum markers, which were determined using standard hospital laboratory methods. Results: The duration of the procedure was 65.5±5.5 (mean±SD) min. The required infusion rate was 8.66±1.50 mg · kg^-1 · hr^-1. The interval from the termination of the infusion until emergence was 10.7±4.2 min. No life-threatening complications or significant changes in liver and renal functions were observed. Conclusions: Propofol can be used effectively and safely for sedation during PVP in terminal cancer patients.