Current perspectives on intrathecal drug delivery

被引:125
作者
Bottros, Michael M. [1 ]
Christo, Paul J. [2 ]
机构
[1] Washington Univ, Sch Med, Dept Anesthesiol, Div Pain Med, St Louis, MO 63110 USA
[2] Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Div Pain Med, Baltimore, MD 21205 USA
关键词
pain control; intrathecal analgesia; drug delivery systems; REFRACTORY CANCER PAIN; SPINAL-CORD STIMULATION; CHRONIC NONCANCER PAIN; COST-EFFECTIVENESS; INFUSION SYSTEMS; MORPHINE THERAPY; OPIOID THERAPY; MANAGEMENT; CONSENSUS; EXPERIENCE;
D O I
10.2147/JPR.S37591
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Advances in intrathecal analgesia and intrathecal drug delivery systems have allowed for a range of medications to be used in the control of pain and spasticity. This technique allows for reduced medication doses that can decrease the side effects typically associated with oral or parenteral drug delivery. Recent expert panel consensus guidelines have provided care paths in the treatment of nociceptive, neuropathic, and mixed pain syndromes. While the data for pain relief, adverse effect reduction, and cost-effectiveness with cancer pain control are compelling, the evidence is less clear for noncancer pain, other than spasticity. Physicians should be aware of mechanical, pharmacological, surgical, and patient-specific complications, including possible granuloma formation. Newer intrathecal drug delivery systems may allow for better safety and quality of life outcomes.
引用
收藏
页码:615 / 626
页数:12
相关论文
共 53 条
[1]   RETRACTED: Comparative efficacy of epidural, subarachnoid, and intracerebroventricular opioids in patients with pain due to cancer - art. no. CD005178 (Retracted Article) [J].
Ballantyne, JC ;
Carwood, CM .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2005, (01)
[2]   COST-ANALYSIS OF 2 IMPLANTABLE NARCOTIC DELIVERY SYSTEMS [J].
BEDDER, MD ;
BURCHIEL, K ;
LARSON, A .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1991, 6 (06) :368-373
[3]  
Bhatia Gaurav, 2013, F1000Res, V2, P96, DOI 10.12688/f1000research.2-96.v4
[4]  
Bier A., 1899, LANGENBECKS ARCH KLI, V51, P361
[5]  
BLACKSHEAR PJ, 1979, MED PROG TECHNOL, V6, P149
[6]  
Britishpainsociety.org, 2008, INTR DRUG DEL MAN PA
[7]   A Cost Utilization Analysis of Intrathecal Therapy for Refractory Cancer Pain: Identifying Factors Associated with Cost Benefit [J].
Brogan, Shane E. ;
Winter, Natalie Best ;
Abiodun, Annalise ;
Safarpour, Reza .
PAIN MEDICINE, 2013, 14 (04) :478-486
[8]   Disease-specific and generic health outcomes: A model for the evaluation of long-term intrathecal opioid therapy in noncancer low back pain patients [J].
Brown, J ;
Klapow, J ;
Doleys, D ;
Lowery, D ;
Tutak, U .
CLINICAL JOURNAL OF PAIN, 1999, 15 (02) :122-131
[9]   Morphologic Changes Associated with Intrathecal Catheters for Direct Delivery to the Central Nervous System in Preclinical Studies [J].
Butt, Mark T. .
TOXICOLOGIC PATHOLOGY, 2011, 39 (01) :213-219
[10]  
Cherny NI, 1997, OTOLARYNG CLIN N AM, V30, P281