Usefulness of epidural catheter with distal subcutaneous reservoir for cancer pain control

: When an effective pain relief cannot be achieved by systemic administration of analgesics, neuraxial opioid therapy such as epidural (EPI) and subarachnoid (SA) catheters should be offered. During the period of 2004 to 2008, EPI (117 patients) and SA (1 patients) with an epidural catheter with subcutaneous reservoir also showed a significant improvement in their pain level calculated by numerical rating scale (NRS). Two cases of infection were caused by a subcutaneous reservoir, however, no serious infections, such as epidural abscess, were observed. Long-term catheter trouble occurred in 15 patients (12.8%) which was considered to be the catheter obstruction caused by epidural fibrosis. It is necessary to establish the common guidelines between hospital doctors and general practitioners to prevent the incidence of the catheter troubles and infections.