Cancer nursing
-
Chronic epidural administration of narcotics and/or local anesthetics is sometimes required in those few patients where utilization of systemic narcotics and appropriate adjuvant medications is unsuccessful in controlling intractable cancer pain. The Du Pen epidural catheter (Davol, Inc.) a silicone-based tunneled catheter modeled after the Hickman central venous catheter, has provided a safe, reliable means of long-term administration of drugs to the epidural space in over 400 patients to date. ⋯ Follow-up care of patients receiving epidural narcotic with or without local anesthetic can be accomplished by a trained home cae team. Successful epidural pain management requires thorough patient and caregiver education, frequent pain assessment, and monitoring of side effects, with close collaboration between patient/family, pharmacist, home care nurse, and physician.