Interventional techniques for the management of cancer pain. Part II. Intrathecal drug delivery techniques

The Pain Management Center specialist offers a wide range of treatment options, standard, conservative, and the most advanced surgical pain treatment. Regarding many research studies confirm the therapeutic importance of interventional (surgical) cancer pain treatment and validity of using even in advanced stage of the disease, especially in cases when pain is resistance to conservative pharmacological treatment. In the article were discussed selected interventional methods for the treatment of chronic pain, of spinal origin. Both neurodestructive techniques and intrathecal drug administration were describes. In most cases their effectiveness is high, but they differ in safety profile and intensity of side effects. More often subarachnoid/extradural continuous analgesia with opioids given through inserted catheter or implanted port is performed. List of approved for intrathecal use drugs which enhanced opioids is getting longer. Most commonly used are: morphine, clonidine, ketamine. The emergence on the market of the new drug zicotonide, undoubtedly make this technique more popular and effective for palliative patients. The drugs are most often used in combination according to recommendation algorithm describes by the Polyanalgesic Consensus Conference for somatic and neuropathic pain.