Neuraxial pain relief for intractable cancer pain

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations


Most patients with cancer pain achieve good analgesia using traditional analgesics and adjuvant medications; however, an important minority of patients (2% to 5%) suffers from severe and refractory cancer pain. For these individuals, spinal analgesics (intrathecal or epidural) provide significant hope for pain relief over months or years of treatment to help improve quality of life. Spinal analgesics have been suggested as the fourth step in the World Health Organization guidelines in the management of cancer pain, and thus the pain physician should be familiar with principles of use. Most patients achieve pain relief using spinal analgesics, with a minimum of complications that are easily managed at home. A variety of opioids, local anesthetics, clonidine, ketamine, and other analgesics are available for the spinal route of administration and should be titrated to clinical effect or intolerable side effect. This article discusses the appropriate selection of patients for spinal analgesics, reviews current recommended infusion systems and current spinal analgesics, discusses possible complications, and includes practical suggestions for patient management.

Original languageEnglish
Pages (from-to)283-289
Number of pages7
JournalCurrent Pain and Headache Reports
Issue number4
StatePublished - Aug 2007

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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