295: Effectiveness and safety of continuous intrathecal morphine delivery in chronic cancer pain before definitive implant of drug delivery system

Polyanalgesic Consensus Conference—2012: Recommendations on Trialing for Intrathecal (Intraspinal) Drug Delivery: Report of an Interdisciplinary Expert Panel

“…Quattrone et al. reported that reductions in VAS score were significantly greater, at rest ( p = 0.01) and while coughing ( p = 0.005), in patients who received a continuous infusion trial than in patients who did not receive a trial before implantation (7). In addition, opioid consumption by these patients was reduced during this period.…”

“…and Shaladi et al. studies experienced continuous morphine infusion trialing‐associated nausea, vomiting, and itching (7,8); however, the vomiting and itching were reported to be resolved after treatment with antiemetic and antihistaminic medications (8). No adverse events occurred in the two case reports (6).…”

“…In the prospective study by Quattrone et al. (7), half of the patients were randomly assigned to receive a continuous morphine infusion trial and the other half did not undergo trialing, whereas all patients from the Shaladi et al. (8) prospective study received the same trial.…”

“…Continuous morphine infusion trials were administered for a period (6,7) that ranged from two to seven days, and the mean initial doses (6,8) ranged from 0.025 to 11.28 mg/d. In the Kim et al.…”

“…(8) study were also required to have maintained this pain reduction at a consistent morphine dose for ≥3 days. In the study by Quattrone et al., the term optimal IT dose was used to describe the dose tested during successful trialing that provided both effective analgesia and minimal side effects (7). In addition to the ≥50% VAS score reduction requirement for a successful trial in the Kim et al.…”