Clinical realities and economic considerations: Efficacy of intrathecal pain therapy

Judith A. Paice*, Wolfhard Winkelmüller, Kim Burchiel, Gabor B. Racz, Joshua P. Prager

*Corresponding author for this work

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Studies of analgesia in cancer patients have revealed that intrathecal administration of opioids can deliver potent analgesia with fewer systemic side effects than equivalent doses of systemic opioids. In addition, several trials have examined the safety and efficacy of this modality in patients with pain of nonmalignant origin. In one survey of 35 physicians involving 429 patients treated with intrathecal therapy, physician reports of global pain relief scores were excellent in 52.4% of patients, good in 42.9%, and poor in 4.8%. In another study of 120 patients, the mean pain intensity score had fallen from 93.6 to 30.5 six months after initiation of therapy. In both studies, patients reported significant improvement in activities of daily living, quality of life measures, and satisfaction with the therapy. Constipation, urinary retention, nausea, vomiting, and pruritus are typical early adverse effects of intrathecal morphine and are readily managed symptomatically. Other potential adverse effects include amenorrhea, loss of libido, edema, respiratory depression, and technical issues with the intrathecal system.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
Volume14
Issue number3 SUPPL.
DOIs
StatePublished - Sep 1 1997

Keywords

  • Adverse effects
  • Analgesia
  • Intrathecal efficacy
  • Morphine
  • Naloxone
  • Neuropathic pain
  • Nociceptive pain
  • Opioids

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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