Uncommon applications for continuous spinal anesthesia

The role that uncommon agents of antinociception, placed intrathecally, play in the control of nociceptive signal transmission in the spinal cord is described. Three specific agents are discussed in detail: baclofen, a gamma aminobutyric acid mimetic agent; clonidine, an alpha-2 agonist; and somatostatin, a neuroinhibitory peptide. In addition, the efficacy of using an implanted pump-catheter system for the long-term infusion of baclofen and octreotide, a somatostatin-like analog, is reviewed.