Intrathecal Therapy for Chronic Pain: Current Trends and Future Needs

Anesthetic Techniques in Pain Management (D Wang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Anesthetic Techniques in Pain Management


The management of chronic pain continues to pose many challenges to healthcare providers. Intrathecal drug delivery systems (IDDS) provide an effective therapy for patients suffering from chronic pain intractable to medical management. However, the clinical growth of intrathecal therapy continues to face many challenges, and is likely underutilized secondary to its high-complexity and limited reimbursement. The clinical utility of IDDS remains limited by lack of prospective randomized, placebo-controlled studies. In addition, there remains a need to enhance physician knowledge on the pharmacodynamics and pharmacokinetics of intrathecal drug delivery and promote further research into this field and drug delivery modalities. The purpose of this article is to provide a comprehensive review of the determinants of successful intrathecal drug delivery with an emphasis on its use in noncancer pain.


Noncancer pain Opioid tolerance Microdosing Complications Indications Trialing Mechanism of action 


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of AnesthesiologyCase Western Reserve UniversityClevelandUSA
  2. 2.Division of Pain MedicineUniversity Hospitals Case Medical CenterClevelandUSA

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