Percutaneous electrical stimulation for the relief of otherwise refractory cancer pain has likewise not yet been evaluated in controlled trials. Case reports--limited essentially to the percutaneous insertion of spinal cord electrodes for dorsal column stimulation--tend to focus on details of the method, to use nonuniform patient selection criteria, and to use heterogeneous pain assessment methods and followup duration. Not all experience is favorable (Meglio, Cioni, and Rossi, 1989). Hence, as Miles and colleagues wrote nearly 20 years ago, "At this stage it seems sensible to concentrate effort on evaluating the method rather than on encouraging widespread and possibly indiscriminate use of what is an expensive use and relatively unproven technique" (Miles, Lipton, Hayward, et al., 1974).
Abdominal Pain
Intraspinal drug delivery systems
Figure 5: Pain Management Plan
Introduction (Invasive nonpharmacologic interventions)
Radiation Therapy
Nerve Blocks
Neuraxial Opioid Infusion
Neuroaugmentation
Index