Epidural opioid therapy for chronic nonmalignant pain: critique of current experience

The current use of epidural catheter techniques for nonmalignant pain follows directly from its successful use of treating intractable malignant pain states. Long-term studies are confirming the safety of epidural infusions of morphine and local anesthetics. Limitations of this technique related to technical catheter considerations, neuropathic pain states, and cost considerations are being reevaluated as more information is developed. Epidural infusions in nonmalignant pain may prove their value in prolonged treatments for conditions that may resolve in time. They are also being utilized increasingly as screening tools prior to implanting permanent infusion pump systems.