Invasive analgesia techniques for advanced cancer pain

Approximately 15% of all cancer pain patients require an invasive technique as an analgesic supplement to their current regimen. Neurolytic blocks should be considered first if they can reduce the present pain intensity by at least 50%. If a one-shot technique is not feasible intraspinal infusions may be beneficial. In general, intrathecal pumps should be used in cases where survival of greater than 6 months is anticipated. Otherwise, implanted epidural infusions seem to be more cost-effective. Finally, for intractable pain in terminally ill patients where loss of bodily function is an acceptable side effect, neuro-ablative surgical procedures should be considered.