1. Neuraxial
opioids are considered for use in patients who have resistant
intractable pain that fails to respond to other treatment options or
pain that responds to
analgesia but for which the doses required result in unacceptable side-effects. 2. Neuraxial opiods can be considered for both chronic non-malignant
pain and chronic
cancer-related pain. 3. Effectiveness in chronic non-malignant
pain and
cancer pain is exerted through the use of either single-agent drugs (
opioids) or a combination of drugs:
opioids, local anaesthetics and other drugs such as clonodine and
ziconotide. 4. Complications of long-term continuous infusion
therapy are related to the insertion process (haematoma), the mechanical device (both pump and
catheter) and the long-term effects of the drugs. 5. Patients will require ongoing ambulatory monitoring and supportive care.