| Percutaneous temporary catheter |
Used extensively both
intraoperatively and
postoperatively. |
Mechanical problems include catheter dislodgment, kinking, or
migration. |
| Useful when prognosis is
limited (<1 month). |
Increased risk of
infection. |
| Permanent
silicone-rubber
epidural |
Catheter implantation is a minor procedure. |
|
| Dislodgment and infection
less common than with
temporary catheters. |
| Can deliver bolus
injections, continuous
infusions, or PCA (with or
without continuous
delivery). |
| Subcutaneous
implanted injection port
|
Increased stability, less risk of dislodgment. |
Implantation more invasive than external catheters. |
| Can deliver bolus injections
or continuous infusions
(with or without PCA). |
Approved only for epidural catheter in United
States. |
| Potential for infection
increases with frequent
injections. |
| Subcutaneous
reservoir
|
Potentially reduced infection in comparison with external system. |
Difficult to access, and fibrosis may occur after repeated injection. |
| Implanted pumps
(continuous and
programmable) |
Potentially decreased risk of infection. |
Need for more extensive operative procedure. |
| Need for specialized
equipment with
programmable systems.
|
