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Indications for Intrathecal Pump Therapy

  • Mercy A. Udoji
  • Helen M. Blake
Chapter

Abstract

Intrathecal drug delivery systems offer an approach for medication administration that is appropriate for patients in whom oral or parenteral therapy is inadequate to control pain complaints or that suffer from deleterious side effects associated with medication administration. Due to rapidly escalating pain or a need for frequent titration of analgesic agents that is often associated with the natural progression of cancer, intrathecal therapy is ideally suited to this population. Intrathecal medications are easily titrated, highly potent, and associated with fewer systemic side effects than parenteral or oral medications. By targeting receptors present in the dorsal horn of the spinal cord, intrathecal drug delivery mechanisms allow for improved pain control with far smaller doses than those required with systemic administration. Multiple systems and medications are available and suitable for intrathecal drug delivery. Intrathecal delivery of medication should be considered in the management of pain associated with cancer.

Keywords

Intrathecal pump Indications Spinal opioid receptors Neuropathic pain Refractory cancer pain Implantable intrathecal pumps Cancer pain Intrathecal analgesia Ziconotide 

Abbreviations

CSF

Cerebrospinal fluid

FDA

Food and Drug Administration

IT

Intrathecal

ITDD

Intrathecal drug delivery

ITP

Intrathecal pump

NMDA

N-methyl-D-aspartate

WHO

World Health Organization

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mercy A. Udoji
    • 1
  • Helen M. Blake
    • 2
  1. 1.Emory University/Atlanta Veterans’ Administration, Department of AnesthesiologyDecaturUSA
  2. 2.Pain and Rehabilitation Specialists of Saint Louis, LLCSt. LouisUSA

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