The lack of an available exteriorized permanent epidural catheter led to the application of the Broviac catheter technology to the development of an epidural catheter. The resulting three-piece silicone-rubber catheter system allows specific spinal-level location of the catheter tip from a lumbar entry site, and exteriorization for ease of self-administration. Fifty-five cancer patients with metastatic disease and intractable pain received 58 catheters. No catheter infections were found during 3891 catheter-days of use, and only 18 minor side effects were noted, with no respiratory depression observed. Hospitalizations for pain control was decreased by 90% after catheter placement. Therefore, the authors recommend early placement of this silicone-rubber epidural catheter to control pain unrelieved by oral analgesics.
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