Intrathecal Octreotide for Relief of Intractable Nonmalignant Pain: 5-Year Experience with Two Cases

Judith A. Paice*, Richard D. Penn, Jeffrey S. Kroin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

SOMATOSTATIN IS DISTRIBUTED in the substantia gelatinosa in the dorsal horn of the spinal cord, and its application has been found to produce an inhibitory effect on nociceptive neurons. Although intraspinal administration of somatostatin-14 produces pain relief in patients with cancer and in postoperative patients, its short half-life limits its clinical usefulness. Octreotide, a synthetic analog of somatostatin, is more stable and has not been associated with neurodegenerative changes when administered intrathecally in dogs. Intrathecal octreotide provides analgesia without adverse drug effects when administered chronically for cancer pain; however, treatment periods have been limited. This article describes the 5-year clinical course of two patients receiving intrathecal octreotide for severe, intractable nonmalignant pain. Included in this description are the results of blinded, randomized "N of 1" trials conducted in each of these patients.

Original languageEnglish (US)
Pages (from-to)203-207
Number of pages5
JournalNeurosurgery
Volume38
Issue number1
DOIs
StatePublished - Jan 1996

Keywords

  • Infusion pumps
  • Intrathecal infusion
  • Octreotide
  • Pain
  • Somatostatin

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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