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

Deer, Timothy R.; Prager, Joshua P.; Levy, Robert M.; Burton, Allen W.; Buchser, Eric; Caraway, David; Cousins, Michael J.; Andrés, José De; Diwan, Sudhir; Erdek, Michael; Grigsby, Eric; Huntoon, Marc A.; Jacobs, Marilyn S.; Kim, Philip; Kumar, Krishna; Leong, Michael S.; Liem, Liong; McDowell, Gladstone; Panchal, Sunil J.; Rauck, Richard; Saulino, Michael; Staats, Peter S.; Stanton‐Hicks, Michael; Stearns, Lisa; Sitzman, B. Todd; Wallace, Mark; Willis, K. Dean; Witt, William; Yaksh, Tony L.; Mekhail, Nagy

doi:10.1111/j.1525-1403.2012.00450.x

Cited by 83 publications

(86 citation statements)

References 36 publications

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“…[10] After carefully weighing the benefits and risks of procedure and IT analgesia, all the 53 patients were elected to undergo the procedure under a local anesthesia in the operating room. The spine area was sterilely prepped and draped, with patients being in the lateral position.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of intrathecal drug delivery system for intractable pain in advanced malignancies

Zheng

Yang

et al. 2017

Medicine

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Pain is prevalent in advanced malignancies; however, some patients cannot get adequate pain relief by conservative routes of analgesic administration or experience serious side effects related to high dose of opioids. For those who have exhausted multimodal conservative analgesic, intrathecal drug delivery is an alternative intervention for truly effective pain management. The objective of this study was to evaluate the clinical efficacy and safety of intrathecal drug delivery system (IDDS) for the treatment of intractable pain in advanced cancer patients.A prospective cohort study was performed between July 2015 and October 2016. Fifty-three patients undergoing intractable cancer-related pain or intolerable drug-related adverse effects were recruited and received IDDS therapy with a patient-controlled intrathecal analgesia pump. The assessment was conducted during admission, in titration period, and followed up monthly to death by scheduled refill visits. Pain numeric rating scale scores, comprehensive toxicity scores, quality of life scores, systemic opioid use (basal and breakthrough dose), intrathecal morphine use (basal and patient-controlled intrathecal analgesia dose), and complications were recorded to evaluate the curative effect and safety.Between baseline and all subsequent follow-ups, statistically significant decreases in pain numeric rating scale scores and comprehensive toxicity scores were verified. A statistical improvement in quality of life scores was found after starting IDDS therapy. Both basal and breakthrough doses of systemic opioid showed a significant decrease during the follow-up period. And there was a modest escalation in the intrathecal morphine dose throughout the duration of study. No infective, device-related, and catheter-related complications were observed.The findings showed that IDDS therapy allowed for rapid and highly effective pain relief with less toxicity in comparison to conservative medications. Patients with advanced malignancies would also benefit from an improvement in the life quality after the procedure. IDDS therapy represented a valuable option for intractable cancer-related pain management.

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Section: Methodsmentioning

confidence: 99%

Evaluation of intrathecal drug delivery system for intractable pain in advanced malignancies

Zheng

Yang

et al. 2017

Medicine

View full text Add to dashboard Cite

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“…In short, if trialing is desired, it can be achieved using several different paradigms: single injection, temporary epidural or intrathecal catheter, or permanent intrathecal catheter [ 1 ]. If the latter is desired-in which the intrathecal catheter that is placed is the one that will be used for longterm, pump-delivered treatment-this procedure is discussed below under tunneled, externalized catheter for palliation.…”

Section: Patient Selectionmentioning

confidence: 98%

Intrathecal Drug Delivery: Surgical Technique

Rosenberg¹

2016

Integrating Pain Treatment Into Your Spine Practice

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“…Industry-sponsored activities to defend and promote arguably hazardous and ineffective intrathecal drug delivery practices include a decade-long series of polyanalgesic consensus documents [28][29][30][31][32][33][34] . Despite manufacturers and FDA having information to the contrary, physician-industry collaborative publications that relied upon incomplete or selective data have provided unrealistic assurances of safety and substantially underestimated risk -specifically, in discussions of paralysis related to implantation of surgical (paddle) spinal cord stimulation leads and death during maintenance of intraspinal opioid therapy, respectively [31][32][33][34][35][36][37] .…”

Section: The Illusory Safety Of Neuromodulation Therapiesmentioning

confidence: 99%

The Enduring Vitality of Implausible Claims for Neurostimulation and Psychosurgical Therapies

Coffey

2015

Stereotact Funct Neurosurg

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

Cited by 83 publications

References 36 publications

Evaluation of intrathecal drug delivery system for intractable pain in advanced malignancies

Evaluation of intrathecal drug delivery system for intractable pain in advanced malignancies

Intrathecal Drug Delivery: Surgical Technique

The Enduring Vitality of Implausible Claims for Neurostimulation and Psychosurgical Therapies

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