[Pain therapy near the spinal marrow. Status survey in Germany and Austria].

OBJECTIVE

The objective of this survey was to investigate the current status of the epidural and intrathecal management in patients with chronic cancer and non-cancer pain in Germany and Austria.

METHODS

In June 1997 a questionnaire was sent to 598 German and Austrian anaesthesiologists specialized in pain therapy. Questions concerning the use of medicaments for epidural and intrathecal treatment of chronic pain were asked.

RESULTS

The response rate was 23%. The data show that 78% of the anaesthesiologists use epidural or intrathecal analgesia in the therapy of chronic pain. Local anaesthetics are used by 85% of these anaesthesiologists, followed by morphine (72%), clonidine (48%), buprenorphine (34%), baclofen (20%), fentanyl (13%) and sufentanil (10%). For most of the treatments local anaesthetics are used, again followed by opioids und clonidine. In the 137 answering pain clinics 79.821 epidural and intrathecal analgetic treatments are performed per year.

DISCUSSION: Epidural and intrathecal pain therapy is frequently used in Germany and Austria, either as a complementary or alternative treatment to systemic pain therapy. Local anaesthetics followed by opioids are the most commonly used medicaments for this treatment. For some of the applied substances neurotoxicological data are lacking. The use of these substances has to be considered very carefully.