尽管有关有效性的证据，但在难治性癌症疼痛治疗中，椎管内药物输送系统的利用率较低。并非所有提供此治疗方式的患者都接受治疗。目前没有证据表明椎管内药物输送系统的使用是否会影响癌症相关疼痛患者的护理场所。本项服务评估比较了成功建立椎管内药物输送系统的患者与选择全面医疗管理的患者的护理场所、死亡场所和每日吗啡等效剂量。回顾性纵向队列研究，比较了45名癌痛患者，其中经椎管内药物输送系统成功输送持续镇痛药物的患者（n=28）与继续接受全面医疗管理的患者（n=17）。与全面医疗管理组相比，椎管内组的社区时间明显更长（中位数126.5天对25.5天， p=0.002），且临终时吗啡等效剂量较低（中位数127.5对440.0，p=0.022）。在晚期癌症患者中，成功建立椎管内镇痛疗法与更长的社区时间和临终时较低的吗啡等效剂量有关。该研究样本量较小，样本是回顾性选择的。然而，这些发现表明在住院环境中投入初始时间可能是有益的。需要进一步研究在较大规模、前瞻性的患者结局研究中进行，以确定更详细的结论。

Intrathecal Drug Delivery Systems are underutilised in the management of refractory cancer pain despite evidence of their efficacy. Not all patients who are offered this treatment modality accept it. There is no current evidence that indicates if the use of intrathecal drug delivery systems impacts on place of care for patients with cancer related pain.This service evaluation compared place of care, place of death and morphine equivalent daily dose at end of life for patients in whom Intrathecal Drug Delivery was successfully established versus those who chose comprehensive medical management.A retrospective longitudinal cohort study of 45 patients with cancer pain comparing those who had ongoing analgesia successfully delivered via an implanted Intrathecal Drug Delivery System (n = 28) with those who continued to receive comprehensive medical management (n = 17).There was a markedly greater time spent in the community in the intrathecal group than the medical management group (median 126.5vs 25.5 days; p = 0.002) and a lower morphine equivalent daily dose at end of life (median 127.5vs 440.0 p = 0.022).In patients with advanced cancer, the successful establishment of intrathecal analgesia is associated with more time in the community and a lower morphine equivalent daily dose at end of life. The study has low numbers, and the sample was retrospectively selected. Nevertheless, these findings suggest the initial investment of time in an inpatient setting may be beneficial. Further research is required, using larger, prospective studies of patient outcomes in this setting.