Methadone in the intrathecal treatment of chronic nonmalignant pain resistant to other neuroaxial agents: the first experience.

Intrathecal drug delivery is a widely used and effective method of treatment for chronic intractable pain. Unfortunately all currently used agents can not provide adequate pain relief in all patients. A prospective study of neuroaxial methadone was performed in 24 patients, all of whom had failed treatment with multiple previous intrathecal drugs. Thirteen patients experienced improvement of their pain control with methadone, nine continued to receive this agent for 6 months with good pain relief, improved quality of life and no side effects. The final rates of methadone infusion were 2.2 times higher than preceding morphine rates. The only observed possible side effect of methadone was transient blurred vision in one patient. Methadone is a promising alternative neuroaxial agent in the treatment of chronic pain.