Intrathecal

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An intrathecal injection (often simply called "intrathecal") is an injection into the spinal canal (intrathecal space surrounding the spinal cord), as in a spinal anaesthesia or in chemotherapy or pain management applications. This route is also used for some infections, particularly post-neurosurgical. The drug needs to be given this way to avoid the blood brain barrier. If the drug were given via other routes of administration where it would enter the blood stream it would be unable to reach the brain. Drugs given intrathecally often have to be made up specially by a pharmacist or technician because they cannot contain any preservative or other potentially harmful inactive ingredients that are sometimes found in standard injectable drug preparations.

[edit] Intrathecal administration of analgesia:

Popular for a single 24-hour dose of analgesia (opioid with Local anesthetic)
Caution because of late onset respiratory depression
Severe pruritus and urinary retention may limit the use of intrathecal morphine
Pethidine has the unusual properties of being both a local anaesthetic and opioid analgesic which occasionally permits its use as the sole intrathecal anaesthetic agent.

[edit] Intrathecal chemotherapy:

Currently, only three agents are licensed for intrathecal chemotherapy
They are methotrexate, cytarabine (a.k.a. Ara-C) and hydrocortisone
Administration of other chemotherapeutic agents with the intrathecal route could lead to fatal outcomes