Epidural sufentanil for cancer pain control in outpatients

Fifteen patients with cancer pain refractory to other methods of pain control were treated with epidural sufentanil. They all suffered from very severe or unbearable pain but had expressed the wish to spend the last period of their lives at home. On the first day of hospitalization, an epidural catheter and a portal catheter were implanted under local anesthesia. Sufentanil was delivered by a portable infusion pump into the portal catheter. The patients remained a further 2-3 days in hospital to titrate the infusion rate to their specific needs and to monitor pain relief and possible side effects. In the home situation, the patients were supervised by their general practitioners. Nine patients had epidural sufentanil as their sole analgesic till they died; six patients needed adjunctive nonepidural medications. There were no epidural- or portal-catheter related infections or cases of respiratory depression. After 1651 patient treatment days, we have found continuous epidural sufentanil infusion to be a safe and effective method for cancer pain control in outpatients.