In patients with cancer pain caused by tumours in the upper thorax, shoulder or neck area the thoracic approach for peridural opiate analgesia is indicated. The thoracic puncture technique is more difficult and the possible complications are more serious than puncture in the lumbar area; it therefore belongs, as pain therapy generally, in the hands of an anaesthesiologist experienced in regional anaesthesia. In selecting the puncture level appropriate to the site of pain, it is necessary to take account of the fact that the vertebral interspace does not correspond with the spinal segment. Only thus can an optimal analgetic effect with a minimal dose b assured.
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