Intrathecal Drug Administration in Chronic Pain Syndromes

Pain Practice

Volumn 14, Issue 5, 2014, Pages 461-476

  Ver Donck, Ann ^a   Vranken, Jan H ^b   Puylaert, Martine ^c   Hayek, Salim ^d   Mekhail, Nagy ^e   Van Zundert, Jan ^c  

^a Pain Center AZ Sint Jan   (Belgium)

^b Medical Centre Alkmaar   (Netherlands)

^c DEPARTMENT OF CARDIOLOGY   (Belgium)

^d UNIVERSITY HOSPITALS OF CLEVELAND   (United States)

^e LERNER RESEARCH INSTITUTE   (United States)

Author keywords

Chronic pain; Evidence based medicine; Intrathecal drug administration; Morphine; Ziconotide

Indexed keywords

4 AMINOBUTYRIC ACID RECEPTOR; ALPHA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; BACLOFEN; HYDROCORTISONE; MORPHINE; N METHYL DEXTRO ASPARTIC ACID RECEPTOR BLOCKING AGENT; N TYPE VOLTAGE DEPENDENT CALCIUM CHANNEL BLOCKING AGENT; OMEGA CONOTOXIN MVIIA; OPIATE AGONIST; PLACEBO; SODIUM CHANNEL BLOCKING AGENT; UNCLASSIFIED DRUG; ANALGESIC AGENT;

ALLODYNIA; AMENORRHEA; ANALGESIA; ARTICLE; CANCER PAIN; CATHETER COMPLICATION; CATHETER MALFUNCTION; CHRONIC PAIN; COHORT ANALYSIS; CONFUSION; CONSTIPATION; DIZZINESS; DRUG EFFICACY; EDEMA; ERECTILE DYSFUNCTION; FOLLOW UP; GAIT DISORDER; GRANULOMA; GROWTH HORMONE DEFICIENCY; GYNECOMASTIA; HUMAN; HYPERALGESIA; HYPOGONADISM; IMPOTENCE; INTRATHECAL CATHETER; LIBIDO DISORDER; MEMORY DISORDER; MYOCLONUS; NAUSEA; NYSTAGMUS; PAIN; PATIENT SELECTION; PROSPECTIVE STUDY; PRURITUS; PSYCHOSIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESPIRATION DEPRESSION; RETROSPECTIVE STUDY; SIDE EFFECT; SPINAL CORD DORSAL HORN; URINE RETENTION; VOMITING; DRUG EFFECTS; INTRASPINAL DRUG ADMINISTRATION; PAIN MEASUREMENT; PROCEDURES; SYNDROME;

ANALGESICS; CHRONIC PAIN; HUMANS; INJECTIONS, SPINAL; MORPHINE; PAIN MEASUREMENT; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SYNDROME;

EID: 84901690180     PISSN: 15307085     EISSN: 15332500     Source Type: Journal    
DOI: 10.1111/papr.12111     Document Type: Review

References (92)

1. Guyatt G, Gutterman D, Baumann MH, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American college of chest physicians task force. Chest. 2006;129:174-181.
2. van Kleef M, Mekhail N, van Zundert J. Evidence-based guidelines for interventional pain medicine according to clinical diagnoses. Pain Pract. 2009;9:247-251.
3. Uhle EI, Becker R, Gatscher S, Bertalanffy H. Continuous intrathecal clonidine administration for the treatment of neuropathic pain. Stereotact Funct Neurosurg. 2000;75:167-175.
4. Cohen SP, Dragovich A. Intrathecal analgesia. Med Clin North Am. 2007;91:251-270.
5. Vissers KC, Besse K, Wagemans M, et al. Pain in patients with cancer. Pain Pract. 2011;11:453-475.
6. Yaksh TL, Rudy TA. Analgesia mediated by a direct spinal action of narcotics. Science. 1976;192:1357-1358.
7. Yaksh TL, Jessell TM, Gamse R, Mudge AW, Leeman SE. Intrathecal morphine inhibits substance P release from mammalian spinal cord in vivo. Nature. 1980;286:155-157.
8. Gerber HR. Intrathecal morphine for chronic benign pain. Best Pract Res Clin Anaesthesiol. 2003;17:429-442.
9. Belverud S, Mogilner A, Schulder M. Intrathecal pumps. Neurotherapeutics. 2008;5:114-122.
10. Turner JA, Sears JM, Loeser JD. Programmable intrathecal opioid delivery systems for chronic noncancer pain: a systematic review of effectiveness and complications. Clin J Pain. 2007;23:180-195.
11. Prager J, Jacobs M. Evaluation of patients for implantable pain modalities: medical and behavioral assessment. Clin J Pain. 2001;17:206-214.
12. Ghafoor VL, Epshteyn M, Carlson GH, Terhaar DM, Charry O, Phelps PK. Intrathecal drug therapy for long-term pain management. Am J Health Syst Pharm. 2007;64:2447-2461.
13. Deer TR, Prager J, Levy R, et al. Polyanalgesic consensus conference-2012: recommendations on trialing for intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2012;15:420-435; discussion 435.
14. Miljanich G, Rauck R, Saulino M. Spinal mechanisms of pain and analgesia. Pain Pract. 2013;13:114-130.
15. Hassenbusch S, Burchiel K, Coffey RJ, et al. Management of intrathecal catheter-tip inflammatory masses: a consensus statement. Pain Med. 2002;3:313-323.
16. Deer T, Krames ES, Hassenbusch SJ, et al. Polyanalgesic consensus conference 2007: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2007;10:300-328.
17. Tucker AP, Lai C, Nadeson R, Goodchild CS. Intrathecal midazolam I: a cohort study investigating safety. Anesth Analg. 2004;98:1512-1520, table of contents.
18. Prochazka J, Hejcl A, Prochazkova L. Intrathecal midazolam as supplementary analgesia for chronic lumbar pain-15 years' experience. Pain Med. 2011;12:1309-1315.
19. Johansen MJ, Gradert TL, Satterfield WC, et al. Safety of continuous intrathecal midazolam infusion in the sheep model. Anesth Analg. 2004;98:1528-1535, table of contents.
20. Fisher K, Coderre TJ, Hagen NA. Targeting the N-methyl-d-aspartate receptor for chronic pain management. Preclinical animal studies, recent clinical experience and future research directions. J Pain Symptom Manage. 2000;20:358-373.
21. Vranken JH, Troost D, de Haan P, et al. Severe toxic damage to the rabbit spinal cord after intrathecal administration of preservative-free S(+)-ketamine. Anesthesiology. 2006;105:813-818.
22. Vranken JH, Troost D, Wegener JT, Kruis MR, van der Vegt MH. Neuropathological findings after continuous intrathecal administration of S(+)-ketamine for the management of neuropathic cancer pain. Pain. 2005;117:231-235.
23. Anderson VC, Burchiel KJ. A prospective study of long-term intrathecal morphine in the management of chronic nonmalignant pain. Neurosurgery. 1999;44:289-300; discussion 300-1.
24. Mironer Y, Haasis J, Chapple I, Brown C, Satterthwaite J. Efficacy and safety of intrathecal opioid/bupivacaine mixture in chronic nonmalignant pain: a double blind, randomized, crossover, multicenter study by the National Forum of Independent Pain Clinicians (NFIPC). Neuromodulation. 2002;5:2008-2213.
25. Van Dongen RT, Crul BJ, De Bock M. Long-term intrathecal infusion of morphine and morphine/bupivacaine mixtures in the treatment of cancer pain: a retrospective analysis of 51 cases. Pain. 1993;55:119-123.
26. Kumar K, Bodani V, Bishop S, Tracey S. Use of intrathecal bupivacaine in refractory chronic nonmalignant pain. Pain Med. 2009;10:819-828.
27. Deer TR, Serafini M, Buchser E, Ferrante FM, Hassenbusch SJ. Intrathecal bupivacaine for chronic pain: a review of current knowledge. Neuromodulation. 2002;5:196-207.
28. Hildebrand KR, Elsberry DD, Deer TR. Stability, compatibility, and safety of intrathecal bupivacaine administered chronically via an implantable delivery system. Clin J Pain. 2001;17:239-244.
29. Wallace MS, Rauck R, Fisher R, Charapata SG, Ellis D, Dissanayake S. Intrathecal ziconotide for severe chronic pain: safety and tolerability results of an open-label, long-term trial. Anesth Analg. 2008;106:628-637, table of contents.
30. Rauck RL, Wallace MS, Leong MS, et al. A randomized, double-blind, placebo-controlled study of intrathecal ziconotide in adults with severe chronic pain. J Pain Symptom Manage. 2006;31:393-406.
31. Shields D, Montenegro R, Ragusa M. Chemical stability of admixtures combining ziconotide with morphine or hydromorphone during simulated intrathecal administration. Neuromodulation. 2005;8:257-263.
32. Deer TR, Prager J, Levy R, 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;15:436-464; discussion 464-466.
33. Perruchoud C, Eldabe S, Durrer A, et al. Effects of flow rate modifications on reported analgesia and quality of life in chronic pain patients treated with continuous intrathecal drug therapy. Pain Med. 2011;12:571-576.
34. Wulf H, Gleim M, Mignat C. The stability of mixtures of morphine hydrochloride, bupivacaine hydrochloride, and clonidine hydrochloride in portable pump reservoirs for the management of chronic pain syndromes. J Pain Symptom Manage. 1994;9:308-311.
35. Shields D, Montenegro R, Aclan J. Chemical stability of an admixture combining ziconotide and bupivacaine during simulated intrathecal administration. Neuromodulation. 2007;10:1-15.
36. Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007;10:7-111.
37. Manchikanti L, Singh V, Derby R, et al. Reassessment of evidence synthesis of occupational medicine practice guidelines for interventional pain management. Pain Physician. 2008;11:393-482.
38. Hayek SM, Deer TR, Pope JE, Panchal SJ, Patel VB. Intrathecal therapy for cancer and non-cancer pain. Pain Physician. 2011;14:219-248.
39. 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;12:345-360.
40. Winkelmuller M, Winkelmuller W. Long-term effects of continuous intrathecal opioid treatment in chronic pain of nonmalignant etiology. J Neurosurg. 1996;85:458-467.
41. Deer TR, Caraway DL, Kim CK, Dempsey CD, Stewart CD, McNeil KF. Clinical experience with intrathecal bupivacaine in combination with opioid for the treatment of chronic pain related to failed back surgery syndrome and metastatic cancer pain of the spine. Spine J. 2002;2:274-278.
42. Roberts L, Finch P, Goucke C, Price L. Outcome of intrathecal opioids in chronic non-cancer pain. Eur J Pain. 2001;5:353-361.
43. Thimineur MA, Kravitz E, Vodapally MS. Intrathecal opioid treatment for chronic non-malignant pain: a 3-year prospective study. Pain. 2004;109:242-249.
44. Kress HG, Simpson KH, Marchettini P, Ver Donck A, Varrassi G. Intrathecal therapy: what has changed with the introduction of ziconotide. Pain Pract. 2009;9:338-347.
45. Hamann S, Sloan P. Oral naltrexone to enhance analgesia in patients receiving continuous intrathecal morphine for chronic pain: a randomized, double-blind, prospective pilot study. J Opioid Manag. 2007;3:137-144.
46. Duse G, Davia G, White PF. Improvement in psychosocial outcomes in chronic pain patients receiving intrathecal morphine infusions. Anesth Analg. 2009;109:1981-1986.
47. Kumar K, Hunter G, Demeria DD. Treatment of chronic pain by using intrathecal drug therapy compared with conventional pain therapies: a cost-effectiveness analysis. J Neurosurg. 2002;97:803-810.
48. Du Pen S, Du Pen A, Hillyer J. Intrathecal hydromorphone for intractable nonmalignant pain: a retrospective study. Pain Med. 2006;7:10-15.
49. Vissers KC, Besse K, Hans G, Devulder J, Morlion B. Opioid rotation in the management of chronic pain: where is the evidence? Pain Pract. 2010;10:85-93.
50. Anderson VC, Cooke B, Burchiel KJ. Intrathecal hydromorphone for chronic nonmalignant pain: a retrospective study. Pain Med. 2001;2:287-297.
51. Hassenbusch SJ, Stanton-Hicks MD, Soukup J, Covington EC, Boland MB. Sufentanil citrate and morphine/bupivacaine as alternative agents in chronic epidural infusions for intractable non-cancer pain. Neurosurgery. 1991;29:76-81; discussion 81-72.
52. 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;12:1481-1489.
53. Ackerman LL, Follett KA, Rosenquist RW. Long-term outcomes during treatment of chronic pain with intrathecal clonidine or clonidine/opioid combinations. J Pain Symptom Manage. 2003;26:668-677.
54. Do Ouro S, Esteban S, Sibirceva U, Whittenberg B, Portenoy R, Cruciani RA. Safety and tolerability of high doses of intrathecal fentanyl for the treatment of chronic pain. J Opioid Manag. 2006;2:365-368.
55. Crain SM, Shen KF. Ultra-low concentrations of naloxone selectively antagonize excitatory effects of morphine on sensory neurons, thereby increasing its antinociceptive potency and attenuating tolerance/dependence during chronic cotreatment. Proc Natl Acad Sci U S A. 1995;92:10540-10544.
56. Grider JS, Harned ME, Etscheidt MA. Patient selection and outcomes using a low-dose intrathecal opioid trialing method for chronic nonmalignant pain. Pain Physician. 2011;14:343-351.
57. Hamza M, Doleys D, Wells M, et al. Prospective study of 3-year follow-up of low-dose intrathecal opioids in the management of chronic nonmalignant pain. Pain Med. 2012;13:1304-1313.
58. Ilias W, le Polain B, Buchser E, Demartini L. Patient-controlled analgesia in chronic pain patients: experience with a new device designed to be used with implanted programmable pumps. Pain Pract. 2008;8:164-170.
59. Staats PS, Yearwood T, Charapata SG, et al. Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS: a randomized controlled trial. JAMA. 2004;291:63-70.
60. Wallace M, Charapata S, Fisher R, et al. Intrathecal ziconotide in the treatment of chronic nonmalignant pain: a randomized, double-blind, placebo-controlled clinical trial. Neuromodulation. 2006;9:75-86.
61. EMEA. Summary of Product Characteristics: Prialt. London: EMEA; 2010.
62. Ellis D, Dissanayake S, McGuire D, et al. Continuous intrathecal infusion of ziconotide for treatment of chronic malignant and nonmalignant pain over 12 months: a prospective. Open-label Study. Neuromodulation. 2008;11:40-49.
63. Raffaeli W, Sarti D, Demartini L, Sotgiu A, Bonezzi C. Italian registry on long-term intrathecal ziconotide treatment. Pain Physician. 2011;14:15-24.
64. Burton AW, Deer TR, Wallace MS, Rauck RL, Grigsby E. Considerations and methodology for trialing ziconotide. Pain Physician. 2010;13:23-33.
65. Dewilde S, Verdian L, Maclaine GD. Cost-effectiveness of ziconotide in intrathecal pain management for severe chronic pain patients in the UK. Curr Med Res Opin. 2009;25:2007-2019.
66. Alicino I, Giglio M, Manca F, Bruno F, Puntillo F. Intrathecal combination of ziconotide and morphine for refractory cancer pain: a rapidly acting and effective choice. Pain. 2012;153:245-249.
67. Deer TR, Kim C, Bowman R, Tolentino D, Stewart C, Tolentino W. Intrathecal ziconotide and opioid combination therapy for noncancer pain: an observational study. Pain Physician. 2009;12:E291-E296.
68. Deer TR, Smith HS, Burton AW, et al. Comprehensive consensus based guidelines on intrathecal drug delivery systems in the treatment of pain caused by cancer pain. Pain Physician. 2011;14:E283-E312.
69. Smith TJ, Staats PS, Deer T, 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;20:4040-4049.
70. Smith TJ, Coyne PJ, Staats PS, et al. An implantable drug delivery system (IDDS) for refractory cancer pain provides sustained pain control, less drug-related toxicity, and possibly better survival compared with comprehensive medical management (CMM). Ann Oncol. 2005;16:825-833.
71. Rauck RL, Cherry D, Boyer MF, Kosek P, Dunn J, Alo K. Long-term intrathecal opioid therapy with a patient-activated, implanted delivery system for the treatment of refractory cancer pain. J Pain. 2003;4:441-447.
72. Ballantyne JC, Carwood CM. Comparative efficacy of epidural, subarachnoid, and intracerebroventricular opioids in patients with pain due to cancer. Cochrane Database Syst Rev. 2005:CD005178.
73. McMillan MR, Doud T, Nugent W. Catheter-associated masses in patients receiving intrathecal analgesic therapy. Anesth Analg. 2003;96:186-190, table of contents.
74. Coffey RJ, Burchiel K. Inflammatory mass lesions associated with intrathecal drug infusion catheters: report and observations on 41 patients. Neurosurgery. 2002;50:78-86; discussion 86-77.
75. Deer TR, Prager J, Levy R, et al. Polyanalgesic consensus conference-2012: consensus on diagnosis, detection, and treatment of catheter-tip granulomas (inflammatory masses). Neuromodulation. 2012;15:483-496.
76. Gupta A, Martindale T, Christo PJ. Intrathecal catheter granuloma associated with continuous sufentanil infusion. Pain Med. 2010;11:847-852.
77. 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;16:251-257.
78. Neuman SA, Eldrige JS, Qu W, Freeman ED, Hoelzer BC. Post dural puncture headache following intrathecal drug delivery system placement. Pain Physician. 2013;16:101-107.
79. Wagemans MF, Bakker EN, Zuurmond WW, Spoelder EM, Van Loenen AC, De Lange JJ. Intrathecal administration of high-dose morphine solutions decreases the pH of cerebrospinal fluid. Pain. 1995;61:55-59.
80. Hayek SM, Veizi IE, Narouze SN, Mekhail N. Age-dependent intrathecal opioid escalation in chronic noncancer pain patients. Pain Med. 2011;12:1179-1189.
81. Wallace MS. Treatment options for refractory pain: the role of intrathecal therapy. Neurology. 2002;59:S18-S24.
82. Abs R, Verhelst J, Maeyaert J, et al. Endocrine consequences of long-term intrathecal administration of opioids. J Clin Endocrinol Metab. 2000;85:2215-2222.
83. Coffey RJ, Owens ML, Broste SK, et al. Mortality associated with implantation and management of intrathecal opioid drug infusion systems to treat noncancer pain. Anesthesiology. 2009;111:881-891.
84. Johnson ML, Visser EJ, Goucke CR. Massive clonidine overdose during refill of an implanted drug delivery device for intrathecal analgesia: a review of inadvertent soft-tissue injection during implantable drug delivery device refills and its management. Pain Med. 2011;12:1032-1040.
85. Schmidtko A, Lotsch J, Freynhagen R, Geisslinger G. Ziconotide for treatment of severe chronic pain. Lancet. 2010;375:1569-1577.
86. Dupoiron D, Bore F, Lefebvre-Kuntz D, et al. Ziconotide adverse events in patients with cancer pain: a multicenter observational study of a slow titration, multidrug protocol. Pain Physician. 2012;15:395-403.
87. Deer TR, Prager J, Levy R, et al. Polyanalgesic consensus conference-2012: recommendations on trialing for intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2012;15:420-435.
88. Rathmell JP, Lake T, Ramundo MB. Infectious risks of chronic pain treatments: injection therapy, surgical implants, and intradiscal techniques. Reg Anesth Pain Med. 2006;31:346-352.
89. Hester SM, Fisher JF, Lee MR, Macomson S, Vender JR. Evaluation of salvage techniques for infected baclofen pumps in pediatric patients with cerebral palsy. J Neurosurg Pediatr. 2012;10:548-554.
90. Baddour LM, Cha YM, Wilson WR. Clinical practice. Infections of cardiovascular implantable electronic devices. N Engl J Med. 2012;367:842-849.
91. Follett KA, Boortz-Marx RL, Drake JM, et al. Prevention and management of intrathecal drug delivery and spinal cord stimulation system infections. Anesthesiology. 2004;100:1582-1594.
92. Deer TR. A prospective analysis of intrathecal granuloma in chronic pain patients: a review of the literature and report of a surveillance study. Pain Physician. 2004;7:225-228.