Table 4. Advantages and Disadvantages of Intraspinal Drug Administration
| System | Advantages | Disadvantages |
| PCA = patient-controlled analgesia. | ||
| 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. | ||
