Programmable Intrathecal Opioid Delivery Systems for Chronic Noncancer Pain: A Systematic Review of Effectiveness and Complications

Turner, Judith A.; Sears, Jeanne M.; Loeser, John D.

doi:10.1097/01.ajp.0000210955.93878.44

Cited by 138 publications

(125 citation statements)

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“…2,3 Meanwhile, a series of studies has shown the effectiveness of continuous intrathecal therapy for both spinal or cerebral spasticity [3][4][5][6][7][8] and chronic pain. 9 The inadequate efficacy and intolerable side effects of oral and transdermal pharmacotherapy for the relief of symptoms in a considerable proportion of patients have led to the increased popularity of intrathecal therapies over the past two decades. The Swiss Paraplegic Centre is one of the worldwide largest centers for the acute care and rehabilitation of patients with spinal cord injuries.…”

Section: Introductionmentioning

confidence: 99%

Device-related complications of long-term intrathecal drug therapy via implanted pumps

et al. 2008

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Study Design: Case series. Objectives: To evaluate the risk of pump-and catheter-related complications of intrathecal drug delivery systems. Setting: Tertiary care center in Switzerland. Methods:The medical records of all in-and out-patient adults treated at our institution during a 12-year period were reviewed. All patients that had received intrathecal drug therapy via an implanted pump were invited to a structured interview. Results: One hundred patients, representing therapy with 175 implanted pumps and 132 intrathecal catheters over 552 years, participated in the study. During the observation period, 217 surgical procedures (including 100 primary pump implants) and 5863 pump refills were performed. The annual rate for complications requiring surgical measures was 10.5%, with 35% being pump related and 65% being catheter related. The incidence of infections in our patients was 0.7% per year; all infections appeared during the first 3 months after implantation of the first pump. Conclusions: Complication rates of the patients treated in our center, where we have long-term experience with the indication, implantation and continuous care of patients with intrathecal infusion systems, are in the lowest ranges when compared with other published studies. We consider intrathecal testing before implantation, standardized perioperative procedures and consequent long-term care of the patients in a specialized outpatient clinic to be essential factors for the avoidance of complications.

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Section: Introductionmentioning

confidence: 99%

Device-related complications of long-term intrathecal drug therapy via implanted pumps

et al. 2008

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“…In our case, the newborn had no signals of opioids dependence and/or neonatal abstinence syndrome, common in oral opioids. Complications differ, and some patients refers mostly nausea/vomiting and pruritus [11].…”

Section: Resultsmentioning

confidence: 99%

Complex regional pain syndrome and pregnancy

Campanharo¹,

Filho²,

Lara³

et al. 2017

Clin Obstet Gynecol Reprod Med

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A 37-year-old patient with Complex Regional Pain Syndrome(CRPS) and continuous intrathecal morphine administration presents to prenatal care pregnant with 16 weeks' gestation. Besides CRPS, she has other medical conditions like obesity, migraine and angina, using topiramate and diltiazem.The discussion goes through an overview of CRPS and chronic pain management in pregnancy. In the end, we include a summary and recommendations based on a brief review of the literature.

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“…Several meta-analyses have evaluated the efficacy of spinal cord stimulation and concluded that there was moderate evidence for improvement in pain [33][34][35][36]. A more recent systematic review evaluated the efficacy of epidural and intrathecal drug delivery systems, and determined that there was a moderate reduction in pain but the long-term effectiveness remains unclear [37].…”

Section: Interventional Treatmentsmentioning

confidence: 99%

A Review of the Common Factors Model and Its Application in Pain Management

Coghill¹

2016

IJCAM

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Pain management providers in the field tend to be eclectic and flexible in their choice of modalities and attempt different treatments until they find something that suits the patient, a phenomenon known as the "Goldilocks effect" which derives from the children's story The Story of the Three Bears. Research studies in pain management have concluded that the diverse treatment interventions currently available all appear to be equivocally effective. In the past, the practice of psychotherapy confronted a similar issue--research studies concluded that all psychotherapies were effective which led to a verdict later termed the "Dodo bird effect" referencing a scene from Alice's Adventures in Wonderland. This conclusion led to the distinction of two possible mechanisms of psychotherapeutic change, specific versus non-specific effects, also known as "common factors." The purpose of the current review is to outline the applicability of the common factors model to pain management and provide supportive evidence from existing research.

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Programmable Intrathecal Opioid Delivery Systems for Chronic Noncancer Pain: A Systematic Review of Effectiveness and Complications

Cited by 138 publications

References 100 publications

Device-related complications of long-term intrathecal drug therapy via implanted pumps

Device-related complications of long-term intrathecal drug therapy via implanted pumps

Complex regional pain syndrome and pregnancy

A Review of the Common Factors Model and Its Application in Pain Management

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