Literature DB >> 21904220

Long-term intrathecal drug administration for chronic nonmalignant pain.

Rui V Duarte1, Jon H Raphael, Elizabeth Sparkes, Jane L Southall, Karen LeMarchand, Robert L Ashford.   

Abstract

BACKGROUND: Chronic pain of nonmalignant origin requires effective long-term treatments, as for many patients pain management will be necessary throughout the rest of their lives. Intrathecal drug delivery systems (IDDS) have become a recognized therapy for the management of severe and otherwise intractable chronic pain. However, it is still not clear whether this treatment can be effective for periods up to 10 years or longer, given the paucity of long-term follow-up. This study sought to examine the effectiveness of IDDS following an average of 13 years postimplantation.
METHODS: Twenty patients participated in a longitudinal study with an average follow-up of 13.5 years (range: 10.4 to 17.9) after IDDS implantation. Investigation was carried out by means of a questionnaire before IDDS and after an average of 4 and 13 years of IDDS therapy. Assessment of pharmacological data and complications/side effects was performed.
RESULTS: Statistically significant improvements between baseline and 4-year assessment were observed for the following sensory and psychosocial variables: pain intensity, pain relief, coping, self-efficacy, depression, quality of life, housework, mobility, sleep, and social life (all P<0.001). No statistically significant changes were detected between assessments at averages of 4 and 13.5 years.
CONCLUSIONS: This study, with one of the longest follow-up intervals reported in the IDDS literature, shows that IDDS has the potential to be a life-long pain management solution in appropriately selected patients with chronic nonmalignant pain.

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Year:  2012        PMID: 21904220     DOI: 10.1097/ANA.0b013e31822ff779

Source DB:  PubMed          Journal:  J Neurosurg Anesthesiol        ISSN: 0898-4921            Impact factor:   3.956


  10 in total

Review 1.  Intrathecal Analgesia for Chronic Refractory Pain: Current and Future Prospects.

Authors:  Catherine Smyth; Nadera Ahmadzai; Jason Wentzell; Ashley Pardoe; Andrew Tse; Tiffany Nguyen; Yvette Goddard; Shona Nair; Patricia A Poulin; Becky Skidmore; Mohammed T Ansari
Journal:  Drugs       Date:  2015-11       Impact factor: 9.546

2.  Neurophysiology of pain and hypnosis for chronic pain.

Authors:  Tiara Dillworth; M Elena Mendoza; Mark P Jensen
Journal:  Transl Behav Med       Date:  2012-03       Impact factor: 3.046

Review 3.  Intrathecal drug delivery for chronic pain management-scope, limitations and future.

Authors:  M Czernicki; G Sinovich; I Mihaylov; B Nejad; S Kunnumpurath; G Kodumudi; N Vadivelu
Journal:  J Clin Monit Comput       Date:  2014-08-31       Impact factor: 2.502

4.  Intrathecal drug delivery for the management of pain and spasticity in adults: an executive summary of the British Pain Society's recommendations for best clinical practice.

Authors:  Rui Duarte; Jon Raphael; Sam Eldabe
Journal:  Br J Pain       Date:  2015-05-27

5.  Hypogonadism and low bone mineral density in patients on long-term intrathecal opioid delivery therapy.

Authors:  Rui V Duarte; Jon H Raphael; Jane L Southall; Mourad H Labib; Andrew J Whallett; Robert L Ashford
Journal:  BMJ Open       Date:  2013-06-20       Impact factor: 2.692

6.  Randomised, double-blind controlled trial by dose reduction of implanted intrathecal morphine delivery in chronic non-cancer pain.

Authors:  Jon H Raphael; Rui V Duarte; Jane L Southall; Peter Nightingale; George D Kitas
Journal:  BMJ Open       Date:  2013-07-31       Impact factor: 2.692

7.  Intrathecal Analgesic Drug Delivery is Effective for Analgesia in a Patient with Post-Poliomyelitis Syndrome: A Case Report.

Authors:  Cornelis W J van Tilburg
Journal:  Am J Case Rep       Date:  2016-12-16

8.  Editorial (Thematic Selection: Spinal Neuropharmacological Agents for the Management of Pain).

Authors:  Rui V Duarte; Jon H Raphael; Sam Eldabe
Journal:  Curr Neuropharmacol       Date:  2017       Impact factor: 7.363

9.  Perioperative Opioid Consumption and Clinical Outcomes in Surgical Patients With a Pre-existing Opioid-Based Intrathecal Drug Delivery System.

Authors:  Ryan S D'Souza; Matthew A Warner; Oludare O Olatoye; Brendan J Langford; Danette L Bruns; Darrell R Schroeder; William D Mauck; Kalli K Schaefer; Nafisseh S Warner
Journal:  Anesth Analg       Date:  2022-01-01       Impact factor: 5.108

10.  Intrathecal drug delivery systems for the management of chronic non-cancer pain: protocol for a systematic review of economic evaluations.

Authors:  Rui V Duarte; Tosin Lambe; Jon H Raphael; Sam Eldabe; Lazaros Andronis
Journal:  BMJ Open       Date:  2016-07-15       Impact factor: 2.692

  10 in total

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