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What are other's experiences? Is it time for a group like PROP to step up and make scientific recommendations on dose limits for IT therapy for non-malignant and malignant pain populations?
Neuromodulation. 2015 Oct 19. doi: 10.1111/ner.12352. [Epub ahead of print]
Trialing and Maintenance Dosing Using a Low-Dose Intrathecal Opioid Method for Chronic Nonmalignant Pain: A Prospective 36-Month Study.
Grider JS1, Etscheidt MA1, Harned ME1, Lee J1, Smith B1, Lamar C1, Bux A2.
Author information
OBJECTIVE:
To evaluate low-dose intrathecal opioid trialing and maintenance with regard to analgesia and psychometric functional capacity.
MATERIALS AND METHODS:
Prospective cohort of subjects offered, trialed and maintained using low-dose opioid therapy via an intrathecal drug delivery system. Analgesia, measured by visual analog scale and the Global Pain Scale, and function, measured by Multidimensional Pain Inventory and Global Pain Scale, are evaluated. Population analysis by age, gender, oral opioid dose, diagnosis, and pain type is reported.
RESULTS:
Fifty-eight subjects enrolled in the 36-month evaluation period with mean opioid intrathecal opioid dose less than 350 μg per day of morphine equivalent utilized. Primary nociceptive pain type were associated with lower intrathecal opioid doses and improved visual analog scale pain rating and improved pain severity and interference on the Multidimensional Pain Inventory.
CONCLUSIONS:
This study adds to the growing body of literature suggesting that low-dose intrathecal analgesia without oral opioid supplementation can be efficacious. It appears that this approach may achieve analgesia with lower doses in those with primary nociceptive pain type.
© 2015 International Neuromodulation Society.
KEYWORDS:
Chronic benign pain; intrathecal drug delivery; intrathecal opioids; oral opioid therapy
Neuromodulation. 2015 Oct 19. doi: 10.1111/ner.12352. [Epub ahead of print]
Trialing and Maintenance Dosing Using a Low-Dose Intrathecal Opioid Method for Chronic Nonmalignant Pain: A Prospective 36-Month Study.
Grider JS1, Etscheidt MA1, Harned ME1, Lee J1, Smith B1, Lamar C1, Bux A2.
Author information
- 1Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
- 2Pain Medicine, Danville Anesthesia Associates, Danville, KY, USA.
OBJECTIVE:
To evaluate low-dose intrathecal opioid trialing and maintenance with regard to analgesia and psychometric functional capacity.
MATERIALS AND METHODS:
Prospective cohort of subjects offered, trialed and maintained using low-dose opioid therapy via an intrathecal drug delivery system. Analgesia, measured by visual analog scale and the Global Pain Scale, and function, measured by Multidimensional Pain Inventory and Global Pain Scale, are evaluated. Population analysis by age, gender, oral opioid dose, diagnosis, and pain type is reported.
RESULTS:
Fifty-eight subjects enrolled in the 36-month evaluation period with mean opioid intrathecal opioid dose less than 350 μg per day of morphine equivalent utilized. Primary nociceptive pain type were associated with lower intrathecal opioid doses and improved visual analog scale pain rating and improved pain severity and interference on the Multidimensional Pain Inventory.
CONCLUSIONS:
This study adds to the growing body of literature suggesting that low-dose intrathecal analgesia without oral opioid supplementation can be efficacious. It appears that this approach may achieve analgesia with lower doses in those with primary nociceptive pain type.
© 2015 International Neuromodulation Society.
KEYWORDS:
Chronic benign pain; intrathecal drug delivery; intrathecal opioids; oral opioid therapy
