Long-term intrathecal opioid therapy with a patient-activated, implanted delivery system for the treatment of refractory cancer pain

Rauck, Richard; Cherry, David; Boyer, Michael F; Kosek, Peter; Dunn, Joseph S.; Alò, Kenneth M.

doi:10.1067/s1526-5900(03)00730-2

Cited by 142 publications

(78 citation statements)

References 27 publications

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“…Chronic pain arises from a variety of causes including traumatic injury, various diseases (like arthritis), surgery, or nerve damage (Phillips 2003). One treatment method for severe chronic pain or spasticity is to implant an intrathecal pump that delivers medication directly into the spinal canal (Erdine and De Andres 2006;Winkelmuller and Winkelmuller 1996;Wermeling 2005;Schug et al 2006;Rauck et al 2003;Deer et al 2004). These pumps are highly effective because they have a direct path into the cerebrospinal fluid (CSF).…”

Section: Introductionmentioning

confidence: 97%

Transdermal power transfer for recharging implanted drug delivery devices via the refill port

Evans

Chiravuri²,

Gianchandani

2009

Biomed Microdevices

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This paper describes a system for transferring power across a transdermal needle into a smart refill port for recharging implantable drug delivery systems. The device uses a modified 26 gauge (0.46 mm outer diameter) Huber needle with multiple conductive elements designed to couple with mechanical springs in the septum of the refill port of a drug delivery device to form an electrical connection that can sustain the current required to recharge a battery during a reservoir refill session. The needle is fabricated from stainless steel coated with Parylene, and the refill port septum is made from micromachined stainless steel contact springs and polydimethylsiloxane. The device properties were characterized with dry and wet ambient conditions. The needle and port pair had an average contact resistance of less than 2 Omega when mated in either environment. Electrical isolation between the system, the liquid in the needle lumen, and surrounding material has been demonstrated. The device was used to recharge a NiMH battery with currents up to 500 mA with less than 15 degrees C of resistive heating. The system was punctured 100 times to provide preliminary information with regard to device longevity, and exhibited about 1 Omega variation in contact resistance. The results suggest that this needle and refill port system can be used in an implant to enable battery recharging. This allows for smaller batteries to be used and ultimately increases the volume efficiency of an implantable drug delivery device.

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Section: Introductionmentioning

confidence: 97%

Transdermal power transfer for recharging implanted drug delivery devices via the refill port

Evans

Chiravuri²,

Gianchandani

2009

Biomed Microdevices

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“…32 Patient-activated dosing using ITDD systems as opposed to continuous infusion also showed significantly reduced pain scores and adverse effects. 33 In continuous intrathecal infusions, the opioid is often combined with a local anaesthetic agent.…”

Section: Itddsmentioning

confidence: 99%

Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

O’Brien

Kane

2014

British Journal of Pain

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The vast majority of cancer patients will experience pain during the course of their illness. Thankfully, in most instances, the consistent application of analgesic guidelines, tailored to the unique needs of each individual patient, will deliver a satisfactory outcome. These guidelines recommend the skilled use of analgesic medications, often in conjunction with a range of adjuvant therapies as may be required. Despite the consistent and rational application of such strategies, it is recognised that a small but significant proportion of cancer patients continue to experience more refractory pain. In addition, these patients may experience a plethora of unwanted dose-limiting side effects associated with their analgesic medication, sometimes even at low dose. All such patients with more complex and refractory pain syndromes require a more comprehensive review and many will require interventional therapy and/or adjuvant approaches. Unfortunately, the availability and accessibility of such services are variable. Even in circumstances in which palliative medicine and pain services co-exist in the same region, there may be poor integration between the two services. Each specialty area holds a unique set of skills and competencies, yet there is considerable overlap. Patient care and outcomes will be enhanced by establishing more formal relationships between these two specialty areas.

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“…В ходе многоцентрового открытого клинического исследо-вания R. Rauck и соавт. [19] проведена оценка эффекта интрате-кального морфина у 199 онкологических больных, имевших ре-зистентный ХБС или неконтролируемые побочные эффекты. Интенсивность болевого синдрома уменьшилась в среднем с 6,1 до 4,2% по ВАШ на 1 мес (31% снижение), оставаясь таковой в течение 13 мес (р<0,05).…”

Section: обзоры литературыunclassified

Long-term intrathecal opioid therapy using implantable programmable devices in the treatment of resistant chronic pain syndrome

Зайцев¹,

Абузарова²,

Куржупов³

et al. 2016

Onkol. Z. im. P.A. Gercena

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Московский научно-исследовательский онкологический институт им. П.А. Герцена -филиал ФГБу «национальный медицинский исследовательский радиологический центр» Минздрава россии, Москва, россия в обзоре обобщен материал зарубежных авторов и собственные исследования по длительной интратекальной опиоидной терапии с использованием имплантируемых программируемых устройств в лечении резистентного хронического болево-го синдрома (ХБС). Показано, что метод длительной интратекальной опиоидной терапии высокоэффективен в отношении ХБС как онкологического, так и неонкологического генеза и позволяет существенно улучшить качество жизни больных.Ключевые слова: хронический болевой синдром, онкологическая боль, интратекальная терапия. Long-term intrathecal opioid therapy using implantable programmable devices in the treatment of resistant chronic pain syndromeA.m. zAITSev, G.r. ABuzArovA, m.I. KurzhuPov, r.r. SArmAnAevA, e.A. PoTAPovA, o.n. KIrSAnovA P.A. herzen moscow oncology research Institute, Branch, national medical radiology research center, ministry of health of russia, moscow, russiaThe review summarizes the material obtained by foreign authors and presents the investigations conducted by the authors of this paper to study long-term intrathecal opioid therapy using implantable programmable devices in the treatment of resistant chronic pain syndrome (cPS). long-term intrathecal opioid therapy is shown to be highly effective in treating cancer-and noncancerrelated cPS and to substantially improve quality of life in patients.

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Long-term intrathecal opioid therapy with a patient-activated, implanted delivery system for the treatment of refractory cancer pain

Cited by 142 publications

References 27 publications

Transdermal power transfer for recharging implanted drug delivery devices via the refill port

Transdermal power transfer for recharging implanted drug delivery devices via the refill port

Pain services and palliative medicine – an integrated approach to pain management in the cancer patient

Long-term intrathecal opioid therapy using implantable programmable devices in the treatment of resistant chronic pain syndrome

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