[Pain therapy with implanted medication pumps for chronic pain.].

Epidural or intrathecal opiate analgesia, combined with bupivacain by means of an implanted pump, represents a possibility for providing good pain management for cancer patients as well as other chronic pain patients. Several indications, for implantation of a percutanously refillable pump are demonstrated in 27 patients. Twenty-four patients were treated with epidural and 3 with intrathecal catheters. Nineteen patients were suffering from chronic pain, and 8 had pain because of cancer. Four patients with chronic pain have been treated with continuous epidural opiate analgesia by means of an implanted pump for more than 2 years and 1 patient for more than 5 years. In the course of 2 years there has been no significant increase in the daily dose of buprenorphin given epidurally to patients with chronic pain. There were no addiction problems with opiates given epidurally or intrathecally by means of implanted pumps. Because of a 13% complication rate, pumps and epidural or intrathecal catheters should only be implanted by an experienced team.