[The use of opioids by the regional route in the treatment of pain].

The decision to administer regional opioids either by an epidural or a subarachnoid route (intrathecal or intraventricular) necessitates a prior multiparametric analysis. When opiate therapy is definitively indicated regional opiate administration usually relays an insufficient or poorly tolerated oral route. The epidural route seems to be the best way for transient indications; the choice of the opioid drug then depends on the local or disseminated character of pain. For definitive opioid treatment, morphine is the only substance which can be used for long periods of time; the choice of the route depends on the life expectancy; epidural way combined with "open devices or half open devices" chiefly concerns patients with a poor life expectancy and a rather low daily morphine regime: a subarachnoid approach is best indicated in cases with good life expectancy, however, other criteria--intellectual, socioeconomical levels and quality of the "support system"--are important factors for the choice of the route and of the type of administration devices.