Treatment of intractable cancer pain by electronically controlled parenteral infusion of analgesic drugs.

Intractable metastatic cancer pain can be controlled in the majority of cases with narcotic drugs. This review focuses on parenteral analgesic therapy; the available drugs, administration systems, and electronic infusion devices. The range of drugs suitable for parenteral therapy, including continuous infusion therapy by subcutaneous, intravenous, or epidural routes is limited both by pharmacokinetic and side effects profiles. Implantable ports and catheter systems permit ambulatory delivery of drugs when combined with portable electronic pumps. This enables patient care to move from a bed-bound hospital therapy to ambulation in the hospital or home. The safeguards, features, and modes of operation of these pump-port-catheter-drug systems are described.