Intrathecal drug delivery in the management of chronic pain

被引：6
作者：
Van Zundert, Jan [1 ,2 ]
Rauck, Richard [3 ,4 ]
机构：
[1] Ziekenhuis Oost Limburg, Intens Care Emergency Med & Multidisciplinary Pain, Dept Anesthesiol, Bessemerstr 478, B-3620 Lanaken, Belgium
[2] Maastricht Univ, Med Ctr, Anesthesiol & Pain Med, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands
[3] Carolinas Pain Inst, Winston Salem, NC 27103 USA
[4] Ctr Clin Res LLC, Winston Salem, NC 27103 USA
来源：
BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY | 2023年 / 37卷 / 02期
关键词：
intrathecal drug; opioid; receptors; ziconotide; local anesthetics; trial; side effects; CONFERENCE PACC RECOMMENDATIONS; CHRONIC NONMALIGNANT PAIN; REFRACTORY CANCER PAIN; MORPHINE INFUSION; OPIOID THERAPY; DOUBLE-BLIND; HYDROMORPHONE; ZICONOTIDE; ANALGESIA; SYSTEM;
D O I：
10.1016/j.bpa.2023.02.003
中图分类号：
R614 [麻醉学];
学科分类号：
100217 ;
摘要：
Targeted intrathecal drug delivery (TIDD) has the objective of bringing the drug(s) close to the receptors influencing pain modulation, and thus reducing the dose and the side effects. Intrathecal drug delivery knew its real start with the development of permanent implantation of intrathecal and epidural catheters, combined with internal or external ports, reservoirs, and programmable pumps. TIDD is a valuable treatment for patients with cancer suffering refractory pain. Patients suffering noncancer-related pain should only be considered for TIDD when all other options have been tested, including spinal cord stimulation. Only two drugs are approved by the US Food and Drug Administration for TIDD administration for chronic pain: morphine and ziconotide as monotherapy. In pain management, off-label use of medication and combination therapy is often reported. The specific action of the intrathecal drugs, the efficacy and safety, is described, as well as the modalities for trialing intrathecal drug delivery and the implantation methods. & COPY; 2023 Elsevier Ltd. All rights reserved.
引用
收藏
页码：157 / 169
页数：13
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