Neuraxial infusions

Phillip C. Phan, Madhuri Are, Allen W. Burton

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

BACKGROUND: Treatment of severe pain in the seriously ill patient, whether cancer-related or not, remains challenging. Although the use of basic medical management strategies is effective in most patients, some 10% to 20% or more cancer patients have pain, which is refractory to traditional pharmacotherapy. It has been suggested that a fourth, "interventional" step be added onto the three-step WHO analgesic ladder. Intraspinal analgesic infusions have been shown to be effective in the treatment of refractory cancer pain and in those patients with intolerable opioid-related side effects. A review of the basic pharmacology, patient selection, implant process, evidence of efficacy, and overview of complications is presented. CONCLUSIONS: There is sufficient consistent evidence (one RCT, numerous prospective and retrospective series) to support the use of intraspinal analgesia for refractory cancer pain.

Original languageEnglish (US)
Pages (from-to)152-160
Number of pages9
JournalTechniques in Regional Anesthesia and Pain Management
Volume9
Issue number3
DOIs
StatePublished - Jul 2005

Keywords

  • Chronic pain
  • Implantable pain pump
  • Intrathecal analgesia
  • Intrathecal therapy
  • Opioids
  • Spinal analgesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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