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The epidural opioid internalized system.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|January 1, 1987
Summary
Implantable epidural ports effectively managed chronic pain in metastatic cancer patients, significantly reducing medication needs and improving quality of life. Devices provided pain relief for 82% of remaining life, allowing more time at home.
Area of Science:
- Pain Management
- Oncology
- Neurosurgery
Background:
- Epidural opioids are established for chronic intractable pain.
- Implantable drug delivery systems offer continuous administration.
- Cancer pain management presents unique challenges.
Purpose of the Study:
- Evaluate the 2-year experience with internalized epidural catheters and injection ports.
- Assess the efficacy and safety of these devices in advanced cancer patients.
- Determine the impact on pain control, medication use, and quality of life.
Main Methods:
- Retrospective analysis of 18 patients with metastatic cancer receiving 21 implanted epidural devices.
- Data collection on pain relief, medication reduction, device functionality, and complications.
- Assessment of device effectiveness during the patients' remaining lifespan.
Main Results:
- Devices eliminated or reduced the need for other pain medications in most patients.
- Effective pain control was achieved for 82% of the remaining lifespan in deceased patients.
- Patients spent 46% of their remaining time at home.
- Common complications included catheter blockage and port leakage; one case of meningitis occurred.
Conclusions:
- Internalized epidural systems provide excellent pain relief for advanced cancer patients.
- These devices improve quality of life by reducing sedative effects of other analgesics.
- Careful patient selection and monitoring are crucial to mitigate risks.