{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:08:01Z","timestamp":1771927681631,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging"],"abstract":"<jats:p>This case report describes the management of a 61-year-old female patient with metastatic adenoid cystic carcinoma and chronic refractory cancer pain. Initially treated with spinal cord stimulation (SCS), she later developed tolerance and inadequate analgesia. An intrathecal drug delivery system (IDDS) was subsequently implanted, and combination therapy with intrathecal morphine and sufentanil was initiated. This regimen achieved significant pain relief, reduced Numerical Rating Scale (NRS) scores, and improved sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI). The case highlights the potential efficacy of combining neuromodulation and intrathecal analgesia in managing complex cancer pain. However, due to limited data on sufentanil use in IDDS and the absence of standardized conversion protocols, further studies are warranted.<\/jats:p>","DOI":"10.3389\/fragi.2026.1710432","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:45:25Z","timestamp":1769582725000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined spinal cord stimulation and intrathecal Morphine\u2013Sufentanil therapy for refractory cancer pain: a case report"],"prefix":"10.3389","volume":"7","author":[{"given":"Zhi Shan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pain Management, Chang Zhi People\u2019s Hospital Affiliated to Chang Zhi Medical College","place":["Chang Zhi, Shanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pain Management, China-Japan Friendship Hospital Affiliated to the Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pain Management, Chang Zhi People\u2019s Hospital Affiliated to Chang Zhi Medical College","place":["Chang Zhi, Shanxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1136\/rapm-2022-103770","article-title":"Controversies in intrathecal drug delivery for cancer pain","volume":"48","author":"Brogan","year":"2023","journal-title":"Regional Anesth. Pain Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1111\/ner.12897","article-title":"Conversion of intrathecal opioids to fentanyl in chronic pain patients with implantable pain pumps: a retrospective study","volume":"22","author":"Daewhan","year":"2019","journal-title":"Neuromodulation J. Int. Neuromodulation Soc."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1097\/j.pain.0000000000000877","article-title":"Prevalence and incidence of chronic pain with or without neuropathic characteristics in patients with cancer","volume":"158","author":"Didier","year":"2017","journal-title":"Pain"},{"key":"B4","volume-title":"Effects of alternating morphine and fentanyl on pain behavior and expression of gray matter \u03bc-receptors,\u03b4 receptors, and \u03b2-arrestin2 around the midbrain aqueduct in rats. Techniques in Regional Anesthesia and Pain Management","author":"Dong","year":"2011"},{"key":"B5","doi-asserted-by":"publisher","first-page":"406","DOI":"10.3969\/j.issn.1006-9852.2021.06.002","article-title":"Expert consensus on spinal cord electrical stimulation for chronic pain","volume":"27","author":"Fan","year":"2021","journal-title":"Chin. J. Pain Med."},{"key":"B6","first-page":"271","article-title":"Clinical effects of surgical electrode implantation for spinal cord electrical stimulation in the treatment of diabetic foot","volume":"51","author":"Fan","year":"2022","journal-title":"J. China Med. Univ."},{"key":"B7","first-page":"1028","article-title":"A randomized, multicenterstudy of the effects of epidural sufentanil for labor analgesia","volume":"26","author":"Geng","year":"2006","journal-title":"Chin. J. Anesthesiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1213\/01.ANE.0000054663.70629.46","article-title":"Minimum analgesic doses of fentanyl and sufentanil for epidural analgesia in the first stage of labor","volume":"96","author":"Giorgio","year":"2003","journal-title":"Anesth. Analgesia"},{"key":"B9","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00520-009-0784-2","article-title":"Intraspinal techniques for pain management in cancer patients: a systematic review","volume":"18","author":"Jeff","year":"2010","journal-title":"Support. Care Cancer Official J. Multinatl. Assoc. Support. Care Cancer"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13256-019-2289-9","article-title":"Malfunctioning sufentanil intrathecal pain pump: a case report","volume":"14","author":"Lindsay","year":"2020","journal-title":"J. Med. Case Rep."},{"key":"B11","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3969\/j.issn.1006-9852.2019.01.012","article-title":"Intrathecal analgesia in the management of refractory pain","volume":"25","author":"Liu","year":"2019","journal-title":"Chin. J. Pain Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1016\/j.neurom.2024.08.006","article-title":"Updates on clinical pharmacology and comorbidity management in intrathecal drug delivery for cancer pain","volume":"20","year":"2024","journal-title":"Neuromodulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"591","DOI":"10.3390\/cancers15030591","article-title":"Update on prevalence of pain in patients with cancer 2022: a systematic literature review and meta-analysis","volume":"15","author":"Snijders","year":"2023","journal-title":"Cancers"},{"key":"B14","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1053\/j.trapm.2011.08.001","article-title":"Intrathecal pump implantation techniques","volume":"15","author":"Sparlin","year":"2011","journal-title":"Tech. Regional Anesth. Pain Manag."},{"key":"B15","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1111\/ner.12538","article-title":"Recommendations on intrathecal drug infusion systems best Practices and Guidelines","volume":"20","year":"2017","journal-title":"Neuromodulation J. Int. Neuromodulation Soc."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1111\/ene.15831","article-title":"Joint european academy of neurology-european pain federation-neuropathic pain special Interest Group of the international association for the study of pain guidelines on neuropathic pain assessment","volume":"30","author":"Truini","year":"2023","journal-title":"Eur. Journal Neurology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1097\/00000542-200003000-00018","article-title":"Comparative spinal distribution and clearance kinetics of intrathecally administered morphine, fentanyl, alfentanil, and sufentanil","volume":"92","author":"Ummenhofer","year":"2000","journal-title":"Anesthesiology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1177\/1049909111426134","article-title":"Intrathecal drug delivery system (IDDS) for cancer pain management","volume":"29","author":"Upadhyay","year":"2012","journal-title":"Am. J. Hospice Palliat. Medicine\u00ae"},{"key":"B19","first-page":"787","article-title":"Expert consensus on refractory cancer pain (2017 edition). China tumor clinic","volume":"44","author":"Wang","year":"2017"},{"key":"B20","first-page":"280","article-title":"Observation on the effect of self-controlled analgesia in postoperative epidural patients with equivalent doses of sufentanil or fentanyl combined with ropivacaine","volume":"20","author":"Xu","year":"2004","journal-title":"J. Clin. Anesthesiol."},{"key":"B21","first-page":"104","volume-title":"Handbook of behavioral medicine scales","author":"Zhang","year":"2001"},{"key":"B22","first-page":"161","article-title":"Subarachnoid injection of opioids for postoperative analgesia","volume":"10","author":"Zhang","year":"2004","journal-title":"Chin. J. Pain Med."},{"key":"B23","first-page":"723","article-title":"Advances in indications and drug selection for implantation of intrathecal drug delivery systems","volume":"24","author":"Zhang","year":"2018","journal-title":"Chin. J. Pain Med."}],"container-title":["Frontiers in Aging"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fragi.2026.1710432\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:14:59Z","timestamp":1771924499000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fragi.2026.1710432\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":23,"alternative-id":["10.3389\/fragi.2026.1710432"],"URL":"https:\/\/doi.org\/10.3389\/fragi.2026.1710432","relation":{},"ISSN":["2673-6217"],"issn-type":[{"value":"2673-6217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"article-number":"1710432"}}