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Marmara Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Marmara Üniversitesi, Nörolojik Bilimler Enstitüsü, İstanbul, Türkiye Drug delivery systems are important tools in the management of chronic severe intractable pain in clinical practice. The administration of opioids for pain reduction was documented in 1970’s and the use of intrathecal drug delivery system (IDDS) to administer opioids in the spinal fl uid compartment for the treatment of pain was introduced in the early 1980s. Opioids act at receptors in the substantia gelatinosa of the spinal cord dorsal horn to yield analgesia. Selecting patients with the right indications, and providing them with adequate education and counseling about all aspects of the process is a key component to ensure a successful outcome. In the operating room, the patient is anesthetized and positioned in the lateral decubitus position. The catheter is introduced subarachnoidally at the L3/L4 or L4/L5 level. The other end of the catheter is carried to the abdomen subcutaneously to connect with the pump that is placed in the pocket over the abdominal fascia. The infusion is started after the operation. The average complication rate is about 20%. In conclusion, drug delivery systems are important tools in the management of chronic severe intractable pain and increase the quality of life in selected patients. Anahtar Kelimeler : Opioid, Infusion, Intrathecal