Intraspinal analgesia includes various approaches for medication administration directly into the spinal canal to diffuse throughout the spinal fluid, including intrathecal injections and implanted devices such as reservoirs or pumps. Intraspinal analgesics have been used for the prevention of procedure-related acute pain. These approaches have been evaluated for their efficacy in the management of intractable pain in patients with cancer. The risk of infection with the long-term use and functioning of indwelling devices and catheters requires consideration. Patient selection for this type of long-term pain management should be considered in terms of resources available and caregivers' ability to provide patient care.