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Journal of Clinical Monitoring and Computing

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01.04.2015 | Review Article

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

verfasst von: M. Czernicki, G. Sinovich, I. Mihaylov, B. Nejad, S. Kunnumpurath, G. Kodumudi, N. Vadivelu

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 2/2015

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Abstract

Intrathecal drug delivery system (IDDS) is a targeted therapy system for treating pain and muscle spasm. IDDS is recommended for the treatment of chronic pain which does not respond to optimal medical management. The aim of this review article is to give an up to date and concise account of the use of IDDS. It will explore the main indications, pre-implantation trials and different implantation techniques, the licensing of drugs for intrathecal use and the adverse effects and benefits of this therapy. IDDS is an invasive technique, which can result in severe morbidity and mortality. The up to date knowledge gained from this article along with the recommendations for improving safety in patients receiving IDDS, makes it a valuable resource for healthcare practitioners. Continued research, including outcome studies of this therapy continues to be necessary.

Cohen SP, Dragovich A. Intrathecal analgesia. Anesthesiol Clin. 2007;25(4):863–82.CrossRefPubMed

Stearns L, Boortz-Marx R, Du Pen S, Friehs G, Gordon M, Halyard M, et al. Intrathecal drug delivery for the management of cancer pain: a multidisciplinary consensus of best clinical practices. J Support Oncol. 2005;3(6):399–408.PubMed

Deer T, Winkelmüller W, Erdine S, Bedder M, Burchiel K. Intrathecal therapy for cancer and nonmalignant pain: patient selection and patient management. Neuromodulation. 1999;2(2):55–66.CrossRefPubMed

Smith TJ, Coyne PJ. How to use implantable intrathecal drug delivery systems for refractory cancer pain. J Support Oncol. 2003;1(1):73–6.PubMed

Burton AW, Rajagopal A, Shah HN, Mendoza T, Cleeland C, Hassenbusch SJ, et al. Epidural and intrathecal analgesia is effective in treating refractory cancer pain. Pain Med. 2004;5(3):239–47.CrossRefPubMed

Smith HS, Deer TR, Staats PS, Singh V, Sehgal N, Cordner H. Intrathecal drug delivery. Pain Physician. 2008;11(2 Suppl):S89–104.PubMed

Paice JA, Penn RD, Shott S. Intraspinal morphine for chronic pain: a retrospective, multicenter study. J Pain Symptom Manag. 1996;11(2):71–80.CrossRef

Koulousakis A, Kuchta J, Bayarassou A, Sturm V. Intrathecal opioids for intractable pain syndromes. Acta Neurochir Suppl. 2007;97(Pt 1):43–8.PubMed

Smith TJ, Staats PS, Deer T, Stearns LJ, Rauck RL, Boortz-Marx RL, et al. Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survival. J Clin Oncol. 2002;20(19):4040–9.CrossRefPubMed

10.

Hassenbusch SJ, Portenoy RK, Cousins M, Buchser E, Deer TR, Du Pen SL, et al. Polyanalgesic Consensus Conference 2003: an update on the management of pain by intraspinal drug delivery—report of an expert panel. J Pain Symptom Manage. 2004;27(6):540–63.CrossRefPubMed

11.

Knight KH, Brand FM, Mchaourab AS, Veneziano G. Implantable intrathecal pumps for chronic pain: highlights and updates. Croat Med J. 2007;48(1):22–34.PubMedCentralPubMed

12.

Deer TR, Smith HS, Burton AW, Pope JE, Doleys DM, Levy RM, et al. Comprehensive consensus based guidelines on intrathecal drug delivery systems in the treatment of pain caused by cancer pain. Pain Physician. 2011;14(3):E283–312.PubMed

13.

Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, et al. Long-term opioid management for chronic noncancer pain. Cochrane Database Syst Rev. 2010(1):CD006605.

14.

Clark JD. Chronic pain prevalence and analgesic prescribing in a general medical population. J Pain Symptom Manag. 2002;23(2):131–7.CrossRef

15.

Patel VB, Manchikanti L, Singh V, Schultz DM, Hayek SM, Smith HS. Systematic review of intrathecal infusion systems for long-term management of chronic non-cancer pain. Pain Physician. 2009;12(2):345–60.PubMed

16.

Raphael JH, Duarte RV, Southall JL, Nightingale P, Kitas GD. Randomised, double-blind controlled trial by dose reduction of implanted intrathecal morphine delivery in chronic non-cancer pain. BMJ Open. 2013;3(7). pii: e003061. doi:10.1136/bmjopen-2013-003061.

17.

Duarte RV, Raphael JH, Sparkes E, Southall JL, LeMarchand K, Ashford RL. Long-term intrathecal drug administration for chronic nonmalignant pain. J Neurosurg Anesthesiol. 2012;24(1):63–70.CrossRefPubMed

18.

Veizi IE, Hayek SM, Narouze S, Pope JE, Mekhail N. Combination of intrathecal opioids with bupivacaine attenuates opioid dose escalation in chronic noncancer pain patients. Pain Med. 2011;12(10):1481–9.CrossRefPubMed

19.

Deer TR, Prager J, Levy R, Burton A, Buchser E, Caraway D, et al. Polyanalgesic consensus conference—2012: recommendations on trialing for intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2012;15(5):420–35; discussion 35.

20.

Deer TR, Prager J, Levy R, Rathmell J, Buchser E, Burton A, et al. Polyanalgesic consensus conference 2012: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2012;15(5):436–64; discussion 64–66.

21.

Plummer JL, Cmielewski PL, Gourlay GK, Owen H, Cousins MJ. Antinociceptive and motor effects of intrathecal morphine combined with intrathecal clonidine, noradrenaline, carbachol or midazolam in rats. Pain. 1992;49(1):145–52.CrossRefPubMed

22.

Siddall PJ, Molloy AR, Walker S, Mather LE, Rutkowski SB, Cousins MJ. The efficacy of intrathecal morphine and clonidine in the treatment of pain after spinal cord injury. Anesth Analg. 2000;91(6):1493–8.CrossRefPubMed

23.

Mercadante S. Problems of long-term spinal opioid treatment in advanced cancer patients. Pain. 1999;79(1):1–13.CrossRefPubMed

24.

Anderson VC, Burchiel KJ. A prospective study of long-term intrathecal morphine in the management of chronic nonmalignant pain. Neurosurgery. 1999;44(2):289–300; discussion-1.

25.

Abs R, Verhelst J, Maeyaert J, Van Buyten JP, Opsomer F, Adriaensen H, et al. Endocrine consequences of long-term intrathecal administration of opioids. J Clin Endocrinol Metab. 2000;85(6):2215–22.CrossRefPubMed

26.

Wallace MS, Charapata SG, Fisher R, Byas-Smith M, Staats PS, Mayo M, et al. Intrathecal ziconotide in the treatment of chronic nonmalignant pain: a randomized, double-blind, placebo-controlled clinical trial. Neuromodulation. 2006;9(2):75–86.CrossRefPubMed

27.

van Hilten BJ, van de Beek WJ, Hoff JI, Voormolen JH, Delhaas EM. Intrathecal baclofen for the treatment of dystonia in patients with reflex sympathetic dystrophy. N Engl J Med. 2000;343(9):625–30.CrossRefPubMed

28.

Rauck RL, Wallace MS, Leong MS, Minehart M, Webster LR, Charapata SG, et al. A randomized, double-blind, placebo-controlled study of intrathecal ziconotide in adults with severe chronic pain. J Pain Symptom Manag. 2006;31(5):393–406.CrossRef

29.

Staats PS, Yearwood T, Charapata SG, Presley RW, Wallace MS, Byas-Smith M, et al. Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS: a randomized controlled trial. JAMA. 2004;291(1):63–70.CrossRefPubMed

30.

Hildebrand KR, Elsberry DD, Deer TR. Stability, compatibility, and safety of intrathecal bupivacaine administered chronically via an implantable delivery system. Clin J Pain. 2001;17(3):239–44.CrossRefPubMed

31.

Rudich Z, Peng P, Dunn E, McCartney C. Stability of clonidine in clonidine-hydromorphone mixture from implanted intrathecal infusion pumps in chronic pain patients. J Pain Symptom Manag. 2004;28(6):599–602.CrossRef

32.

Taira T, Kawamura H, Tanikawa T, Iseki H, Kawabatake H, Takakura K. A new approach to control central deafferentation pain: spinal intrathecal baclofen. Stereotact Funct Neurosurg. 1995;65(1–4):101–5.CrossRefPubMed

33.

Mekhail N, Mahboobi R, Farajzadeh Deroee A, Costandi S, Dalton J, Guirguis M, et al. Factors that might impact intrathecal drug delivery (IDD) dose escalation: a longitudinal study. Pain Pract. 2014;14(4):301–08.

34.

Lim HS, Kim JM, Choi JG, Ko YK, Shin YS, Jeon BH, et al. Intrathecal ketamine and pregabalin at sub-effective doses synergistically reduces neuropathic pain without motor dysfunction in mice. Biol Pharm Bull. 2013;36(1):125–30.CrossRefPubMed

35.

Engle MP, Vinh BP, Harun N, Koyyalagunta D. Infectious complications related to intrathecal drug delivery system and spinal cord stimulator system implantations at a comprehensive cancer pain center. Pain Physician. 2013;16(3):251–7.PubMed

36.

Follett KA, Boortz-Marx RL, Drake JM, DuPen S, Schneider SJ, Turner MS, et al. Prevention and management of intrathecal drug delivery and spinal cord stimulation system infections. Anesthesiology. 2004;100(6):1582–94.CrossRefPubMed

37.

Duarte RV, Raphael JH, Southall JL, Baker C, Hanu-Cernat D. Intrathecal inflammatory masses: is the yearly opioid dose increase an early indicator? Neuromodulation. 2010;13(2):109–13.CrossRefPubMed

38.

Coffey RJ, Owens ML, Broste SK, Dubois MY, Ferrante FM, Schultz DM, et al. Mortality associated with implantation and management of intrathecal opioid drug infusion systems to treat noncancer pain. Anesthesiology. 2009;111(4):881–91.CrossRefPubMed

39.

Gaiser RR, Berkowitz DH, Chou D. Epidural blood patch in a patient taking enoxaparin. J Clin Anesth. 2004;16(5):386–8.CrossRefPubMed

40.

Duarte RV, Raphael JH, Haque MS, Southall JL, Ashford RL. A predictive model for intrathecal opioid dose escalation for chronic non-cancer pain. Pain Physician. 2012;15(5):363–9.PubMed

41.

Duarte RV, Raphael JH, Southall JL, Labib MH, Whallett AJ, Ashford RL. Hypogonadism and low bone mineral density in patients on long-term intrathecal opioid delivery therapy. BMJ Open. 2013;3:e002856. doi:10.1136/bmjopen-2013-002856.

42.

Finch PM, Price LM, Pullan PT, Drummond PD. Effects of testosterone treatment on bone mineral density in hypogonadal men receiving intrathecal opioids. Pain Pract. 2014. doi:10.1111/papr.12190.

43.

Prager J, Deer T, Levy R, Bruel B, Buchser E, Caraway D, et al. Best practices for intrathecal drug delivery for pain. Neuromodulation. 2014;17(4):354–72.CrossRefPubMed

44.

Winkelmüller M, Winkelmüller W. Long-term effects of continuous intrathecal opioid treatment in chronic pain of nonmalignant etiology. J Neurosurg. 1996;85(3):458–67.CrossRefPubMed

45.

Ruan X. Drug-related side effects of long-term intrathecal morphine therapy. Pain Physician. 2007;10(2):357–66.PubMed

46.

Roberts LJ, Finch PM, Goucke CR, Price LM. Outcome of intrathecal opioids in chronic non-cancer pain. Eur J Pain. 2001;5(4):353–61.CrossRefPubMed

47.

Cheng JK, Chen CC, Yang JR, Chiou LC. The antiallodynic action target of intrathecal gabapentin: Ca2+ channels, KATP channels or N-methyl-d-aspartic acid receptors? Anesth Analg. 2006;102(1):182–7.CrossRefPubMed

48.

Belfrage M, Segerdahl M, Arnér S, Sollevi A. The safety and efficacy of intrathecal adenosine in patients with chronic neuropathic pain. Anesth Analg. 1999;89(1):136–42.PubMed

49.

Karlsten R, Gordh T. An A1-selective adenosine agonist abolishes allodynia elicited by vibration and touch after intrathecal injection. Anesth Analg. 1995;80(4):844–7.PubMed

50.

Rane K, Segerdahl M, Goiny M, Sollevi A. Intrathecal adenosine administration: a phase 1 clinical safety study in healthy volunteers, with additional evaluation of its influence on sensory thresholds and experimental pain. Anesthesiology. 1998;89(5):1108–15; discussion 9A.

51.

Nielsen CK, Lewis RJ, Alewood D, Drinkwater R, Palant E, Patterson M, et al. Anti-allodynic efficacy of the chi-conopeptide, Xen2174, in rats with neuropathic pain. Pain. 2005;118(1–2):112–24.CrossRefPubMed

52.

Szabo T, Olah Z, Iadarola MJ, Blumberg PM. Epidural resiniferatoxin induced prolonged regional analgesia to pain. Brain Res. 1999;840(1–2):92–8.CrossRefPubMed

53.

Deer T, Krames ES, Hassenbusch S, Burton A, Caraway D, Dupen S, et al. Future directions for intrathecal pain management: a review and update from the interdisciplinary polyanalgesic consensus conference 2007. Neuromodulation. 2008;11(2):92–7.CrossRefPubMed

54.

Kan J, Yang Z, Tang K, Cheng G. Pumping performance of a new piezoelectric pump for drug delivery. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2004;21(2):297–301.PubMed

55.

Kunnumpurath S, Srinivasagopalan R, Vadivelu N. Spinal cord stimulation: principles of past, present and future practice: a review. J Clin Monit Comput. 2009;23(5):333–9.CrossRefPubMed

56.

Onofrio BM, Yaksh TL. Long-term pain relief produced by intrathecal morphine infusion in 53 patients. J Neurosurg. 1990;72(2):200–9.CrossRefPubMed

Titel: Intrathecal drug delivery for chronic pain management-scope, limitations and future
verfasst von: M. Czernicki
G. Sinovich
I. Mihaylov
B. Nejad
S. Kunnumpurath
G. Kodumudi
N. Vadivelu
Publikationsdatum: 01.04.2015
Verlag: Springer Netherlands
Erschienen in: Journal of Clinical Monitoring and Computing / Ausgabe 2/2015
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-014-9607-1

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