Interventional analgesia: epidural and subarachnoid therapy.

The provisionof analgesiaof any typeis, by definition, interventional.A recommendationof epiduralor spinal opioid therapycan beregardedas occupyingapositionatthefarextremeof the spectrumof interventional analgesictreatment.Spinal opioid therapy can reasonablybe groupedtogether with analgesicmodalitiessuchasnerve blocks andsome neurosurgery.Interventional techniquesof analgesia generallyentailsomeadditionalriskto thepatient,as well assome additional effort from practitioners,the patient andtheir family. The true test of the utility of interventional analgesic therapyis whethera techniquecontiibutes further to patientand family well beingthanwould more conventional treatment. Widespreadclinical experiencewith epidural and spinal opioid therapyindicate thatthe minimal risks and investmentof time required to learnabout and maintain treatmentjustify its use in selected patients.