TY - JOUR
T1 - Clinical realities and economic considerations
T2 - Efficacy of intrathecal pain therapy
AU - Paice, Judith A.
AU - Winkelmüller, Wolfhard
AU - Burchiel, Kim
AU - Racz, Gabor B.
AU - Prager, Joshua P.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1997/9
Y1 - 1997/9
N2 - 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.
AB - 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.
KW - Adverse effects
KW - Analgesia
KW - Intrathecal efficacy
KW - Morphine
KW - Naloxone
KW - Neuropathic pain
KW - Nociceptive pain
KW - Opioids
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U2 - 10.1016/S0885-3924(97)00167-X
DO - 10.1016/S0885-3924(97)00167-X
M3 - Article
C2 - 9291707
AN - SCOPUS:0343488396
SN - 0885-3924
VL - 14
SP - S14-S26
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 3 SUPPL.
ER -