Chronic pain has a huge global prevalence of 20% and in a country like India which has been labeled by the UN as the most populous country in April 2023, the problem is likely to explode and pose a huge challenge to Indian Practitioners. An addition to this can also be due to an expected doubling of individuals over 65 years of age by rises in the aging population. Pharmacotherapy which is the mainstay for conservative medical management (CMM) often seems to be inadequate and/or has a potential for a range of side effects. The patients who are refractory to all forms of CMM move up on the treatment algorithm for pain interventions.
A 61-year old gentleman was admitted with adeno-carcinoma of prostate, with bone scan showing some uptake in his ribs (possible metastasis). He had no significant medical problems except for colitis. He was an ex-smoker with two uneventful general anaesthetics in the past. After optimal pre-operative investigations, he was posted for radical prostatectomy.
A thoracic (T) epidural catheter was inserted at T10–11 spinal level after administering general anaesthesia. No blood or clear fluid was in
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