Pain Management, Focal Instillation of Opiates in the Central Nervous System

  • Charles E. Poletti
Part of the Readings from the Encyclopedia of Neuroscience book series (REN)


The use of implantable systems for the long-term focal delivery of pharmacologic agents to the central nervous system (CNS) represents a major therapeutic advance. These systems can now be used to deliver opiates, hormones, neurotransmitters, antibiotics, anticoagulants, oncolytic agents, and other compounds targeted to the epidural space, cerebrospinal fluid, neu-raxis, or bloodstream. In the management of pain states this approach has the advantage of avoiding both the systemic effects associated with high-dose narcotics and the problems associated with the surgical destruction of portions of the nervous system.


Epidural Space Opiate Receptor Phantom Limb Pain Spinal Subarachnoid Space Spinal Morphine 
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Further reading

  1. Cousin MJ, Mather LE (1984): Intrathecal and epidural administration of opioids. Anesthesiology 61:276–310CrossRefGoogle Scholar
  2. Poletti CE, Schmidek HH, Sweet WH, Pilon RN (1982): Pain control with implantable systems for the long-term infusion of intraspinal opioids in man. In: Operative Neurosurgical Techniques 2:1199–1210Google Scholar
  3. Yaksh TL (1981): Spinal opiate analgesia: characteristics and principle of action. Pain 11:293–346CrossRefGoogle Scholar

Copyright information

© Birkhäuser Boston, Inc. 1988

Authors and Affiliations

  • Charles E. Poletti

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