[Air repatriation by a low-cost company for a patient in palliative care with epidural analgesia]

Air medical repatriation: compassionate and palliative care consideration during transport

As the world's population ages, the number of elderly and very elderly international travelers continues to increases. Many of these travelers are afflicted with multiple, often severe, medical conditions; in fact, a significant portion of these elderly travelers are considered end stage with respect to their disease state. While traveling, they are exposed to travel hazards and deterioration of their already compromised health. Once acute illness or injury occurs, medically appropriate, compassionate repatriation of these elderly patients is associated with a range of complex challenges. In this series, we present 4 cases that demonstrate these challenges.

[Locoregional analgesia in palliative care: a 4-year survey]

It could append that patient pain relief in palliative care is not achieved despite the use of opioids and the multimodal approach. Therefore, regional techniques are used in the palliative care unit of the Limoges University Hospital since four years.

PATIENTS AND METHODS

From October 2006 to September 2010, every patient under regional technique was followed with a specific form. The items collected were demographic characteristics, underlying disease, and associated treatments. The efficacy of regional techniques on pain was scored.

RESULTS

Sixty-three patients, 39 males and 24 females, mean age 59 years, were treated by 104 regional procedures. There were 49 neuroaxial analgesia (40 spinal and nine epidural), 39 peripheral nerve blocks including 25 iliofascial blocks and 16 blocks for nerves of the scalp, face and neck. In 67.5% of the cases, the regional techniques provided adequate pain relief. For 24% of the cases, the results were uncompleted. Regional techniques were unsuccessful in 8.5%.

CONCLUSION

Despite this underperformance in terms of pain control, a multicenter study is ongoing to evaluate the improvement of quality of life induced by the regional techniques.