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Intrathecal Drug Delivery

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Pain Medicine

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Abstract

Intrathecal drug delivery may be performed for malignant pain, nonmalignant pain, and spasticity. In all cases, patients must have persistent, debilitating pain or spasticity not responsive to more conservative treatments. They must also first undergo a trial of neuraxially administered medication showing at least a 50 % improvement in pain or functional status. These patients must be very carefully selected; contraindications include but are not limited to concurrent active infection, severe psychological comorbidities (e.g., substance abuse), and an inability to comply with medication refill schedule.

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Implantation, revision, or replacement of catheter 62350

Implantation, revision, or replacement of pump 62360

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Additional Reading

  • Deer TR, Smith HS, Burton AW, et al. Comprehensive consensus guidelines on intrathecal drug delivery systems in the treatment of pain caused by cancer pain. Pain Physician. 2011;214:E283–312.

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  • Deer TR, Smith HS, Cousins M, et al. Consensus guidelines for the selection and implantation of patients with noncancer pain for intrathecal drug delivery. Pain Physician. 2010;13:E175–213.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Christopher R. Abrecht MD & Sanjeet Narang MD

Authors
  1. Christopher R. Abrecht MD
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  2. Sanjeet Narang MD
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Corresponding author

Correspondence to Sanjeet Narang MD .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    R. Jason Yong

  2. Department of Anesthesia and Perioperative Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts, USA

    Michael Nguyen

  3. Department of Anesthesiology Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Ehren Nelson

  4. Harvard Medical School, Brigham and Women’s Health Care Center at Chestnut Hill, Center for Perioperative Research, Sedation for Interventional Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Richard D. Urman

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© 2017 Springer International Publishing Switzerland

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Abrecht, C.R., Narang, S. (2017). Intrathecal Drug Delivery. In: Yong, R., Nguyen, M., Nelson, E., Urman, R. (eds) Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-43133-8_102

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  • DOI: https://doi.org/10.1007/978-3-319-43133-8_102

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43131-4

  • Online ISBN: 978-3-319-43133-8

  • eBook Packages: MedicineMedicine (R0)

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