Anomalies in Chemoport Insertion: Unraveling the Complexity of Guidewire Knotting in a Patient with Hodgkin’s Lymphoma - A Case Analysis

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Authors

1 Department of Anesthesiology, Fukushima Medical University School of Medicine, Japan.

2 Department of Anesthesiology, Fukushima Medical University School of Medicine., Center for Pain Management, Fukushima Medical University Hospital, Hikarigaoka, Fukushima, Japan.

3 1Department of Anesthesiology, Fukushima Medical University School of Medicine, Japan.

Abstract

Postoperative pain with motion can severely limit mobilization and rehabilitation, emphasizing the need for effective analgesic strategies. A 26-year-old male with hidradenitis suppurativa involving both inguinal regions, both axillae, and the perianal area underwent three debridement sessions under general anesthesia, resulting in open wounds. Pain at rest showed a downward trend with oral administration of milogabalin, tramadol, acetaminophen, and celecoxib. However, the patient was utterly unable to get out of bed due to severe pain when he moved especially in the groin and perineal areas. Administration of a mixture of fentanyl and ketamine using an intravenous patient-controlled analgesia (IV-PCA) device was prescribed (administered twice 15 minutes apart before afternoon rehabilitation). The patient regained mobility from the first day of administration. The use of IV-PCA was discontinued on POD 21. The patient was discharged uneventfully on POD 28. Administering opioids intravenously in a setting without direct physician supervision presents significant management challenges. In such situations, there are advantages to using IV-PCA devices for preemptive analgesia.

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