IT pumps and oral opioids

[kstarm]

Chatting with Medtronic at a skills thing. Rep tells me they "never" see patients on oral opioids following placement of IT pump for pain. I spend ~50% of my time in the hospital and have only seen patients that have IT pumps also on oral opioids. I don't do pumps, but I'm guessing this is somewhere in between.

For people placing/managing pumps for non-cancer pain what ballpark % of your patients are also on oral opioids?

---

Members don't see this ad.

 

[Taus]

Never seen one not on orals....

 

[101N]

ITO for CNP needs a medicare review, yesterday. All this is is MAT by
another name and more expensive route.

Pain Med. 2014 Nov;15(11):1823-4. doi: 10.1111/pme.12576. Epub 2014 Oct 3.
Intrathecal opioids for chronic pain: a call for evidence.
Harden RN1, Argoff CE, Williams DA.

 

[epidural man]

I do think that having patients off oral opioids with a pump is probably becoming much more common with the introduction and implementation of ultra-low dose infusion. The reason is - if done correctly - the ultra-low dosing only works if the patient is completely off oral opioids for an extended period before the pump is placed. Then if it works, there isn't reason to put back on orals.

 

[lobelsteve]

50-100% from what I have reviewed. If they do not get the PAT bolus doser, then they may have BTP med needs. I have reviewed dozens of cases of pumps and increased oral opiates afterwards. A downward titration on orals should be mandatory.