THE INAPPROPRIATE USE OF THE EPIDURAL ROUTE IN CANCER PAIN

There continues to be controversy concerning the optimal use of the ep idural route in cancer pain. Although spinal opioids undoubtedly give long-lasting analgesia with low doses, indiscriminate use cannot be re commended. Inappropriate indications for the epidural route are report ed in three patients who required home palliative care. In contrast to epidural treatment, which caused sa,ere clinical problems, simpler me asures, including oral and subcutaneous opioids, were able to give ade quate analgesia and a better quality of life. Education of nursing sta ff and family is necessary when using opioid epidural analgesia at hom e. Wide dissemination of World Health Organization (WHO) guidelines am ong doctors and health-care workers can avoid the use of unnecessary a nd complicated techniques and improve the treatment of terminally ill patients suffering from cancer pain. (C) S. Mercadante, 1997.