Neuraxial AnaJgesia

Abstract

Neuraxial drug administration describes techniques that deliver drugs in close proximity to the spinal cord, i.e. intrathecally into the CSF or epidurally into the fatty tissues surrounding the dura, by injection or infusion. This approach was initially developed in the form of spinal anaesthesia over I 00 years ago. Since then, neuraxial drug administration has •evolved and now includes a wide range of techniques to administer a large number of different drugs to provide anaesthesia, but also analgesia and treatment of a variety of acute and chronic settings. The choice of systems and drugs is based on the nature and duration of the patient's pain, his or her other medical problems, and patient resources. Various delivery systems are available for intraspinal access, including short-term epidural . catheters, permanent epidural or intrathecal catheters, implantable epidural or intrathecal ports, or implanted intrathecal catheter and pumps. The use of intraspinal drug delivery should be based upon the principle of optimum benefit and minimal harm for both the patient and the health system as a whole. Consequently, technical improvement is still necessary to help reduce the complications and side effects associated with the procedure. Key Words: Neuraxial analgesia; Intrathecal drug delivery; Implantable pain pump; Spinal analgesia; Opioids; Chronic pain; Neuraxial infusions.