Revue médicale de la Suisse romande
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Spinal administration of morphine and other opiates has been used in clinical practice since many years, particularly in the outpatient management of cancer pain patients. The rationale and the safety of chronic spinal opiate administration is well established and not questioned anymore. However, the indications to use these therapies remain unclear, essentially because no controlled studies have ever shown the advantages of these treatments. ⋯ This raises technological and financial issues, as well as management problems related to the home care system. The choices that have to be made should include the home physician, the home care nursing team as well as the hospital based pain management team. This short overview will deal with some of these aspects.