Intraspinal therapy in the management of refractory cancer pain

Abstract

Intraspinal catheter delivery systems are presently utilized in patients with both cancer and non-cancer indications. Patients with cancer pain conditions and a limited life expectancy presently have the widest applicability for the systems. Placement of these systems and subsequent management of the patient's pain represent two different aspects to the care involved with intraspinal catheters. Once the skills are developed for placement of these catheters the practitioner must then develop the skill for subsequent management of the patients' pain. Management issues are much more complex and difficult than placement technique alone. Cancer pain is dynamic in nature and requires a complete knowledge of available agents, routes of administration, and the ability to deal with potential risks and complications. This chapter focuses on these issues, allowing the pain management practitioner a better understanding of catheter systems indicated in particular patient populations. It also describes catheter systems and the subsequent management of pain in patients who have had these systems implanted.