Neuraxial infusions

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

doi:10.1053/j.trap.2005.06.008

Neuraxial infusions

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

Research output: Contribution to journal › Article › peer-review

3 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 language	English (US)
Pages (from-to)	152-160
Number of pages	9
Journal	Techniques in Regional Anesthesia and Pain Management
Volume	9
Issue number	3
DOIs	https://doi.org/10.1053/j.trap.2005.06.008
State	Published - Jul 2005
Externally published	Yes

Keywords

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

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

Access to Document

10.1053/j.trap.2005.06.008

Cite this

@article{a3e3afd6d5824afa9377ffca0a163fc6,

title = "Neuraxial infusions",

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.",

keywords = "Chronic pain, Implantable pain pump, Intrathecal analgesia, Intrathecal therapy, Opioids, Spinal analgesia",

author = "Phan, {Phillip C.} and Madhuri Are and Burton, {Allen W.}",

year = "2005",

month = jul,

doi = "10.1053/j.trap.2005.06.008",

language = "English (US)",

volume = "9",

pages = "152--160",

journal = "Techniques in Regional Anesthesia and Pain Management",

issn = "1084-208X",

publisher = "W.B. Saunders Ltd",

number = "3",

}

TY - JOUR

T1 - Neuraxial infusions

AU - Phan, Phillip C.

AU - Are, Madhuri

AU - Burton, Allen W.

PY - 2005/7

Y1 - 2005/7

N2 - 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.

AB - 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.

KW - Chronic pain

KW - Implantable pain pump

KW - Intrathecal analgesia

KW - Intrathecal therapy

KW - Opioids

KW - Spinal analgesia

UR - http://www.scopus.com/inward/record.url?scp=25444504330&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=25444504330&partnerID=8YFLogxK

U2 - 10.1053/j.trap.2005.06.008

DO - 10.1053/j.trap.2005.06.008

M3 - Article

AN - SCOPUS:25444504330

SN - 1084-208X

VL - 9

SP - 152

EP - 160

JO - Techniques in Regional Anesthesia and Pain Management

JF - Techniques in Regional Anesthesia and Pain Management

IS - 3

ER -

Neuraxial infusions

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this