The epidural opioid internalized system

For several years opioids have been given epidurally with success to control chronic intractable pain. The authors report their 2-year experience with internalization of the epidural catheter and injection port in 18 patients at University Hospital, Saskatoon. In all, 21 devices were used. All patients had metastatic cancer; 16 are now dead. The need for other medications was eliminated with 9 and reduced with 12 devices. In the patients who died, the devices were effective for 82% of their remaining life-span. They were able to spend 46% of this time at home. Blockage of the epidural end of the device was the most common mechanical problem, followed by leakage from the port. One patient suffered meningitis after 11 days as a result of subarachnoid placement of the catheter but responded to removal of the device and antibiotic therapy. The authors have been impressed with the excellent pain relief afforded to many of these patients, and their ability to enjoy life free of the sedative effects of other methods of narcotic administration.