Implanted Drug Delivery Systems

  • Lisa Jo Stearns


Implanted Drug Delivery Systems are recommended to patients whose pain is poorly controlled with oral or parenteral medication or to those who experience drug related toxicities. Administration of intrathecal opioids and adjuvant medications allows reduction of up to 200% of oral or parenteral pain medication.1-3 In 1979, Wang and colleagues demonstrated the efficacy of intrathecal morphine in cancer patients.4 Since then, the adoption and use of intrathecal therapies have rapidly developed. Many medications have been trialed intrathecally and accepted into clinical practice with and without scientific support. In 2000, Hassenbusch and Portenoy gathered a team of clinical experts to establish best practice guidelines based on scientific evidence of safety, efficacy, and/or broad clinical usage. The panel surveyed implanting physicians to determine methods of drug selection and drug combination as well as clinical decision making with ongoing intrathecal therapy. The panel examined evidence for safety and efficacy of individual and combinations of medications utilized in intrathecal therapy. The panel established intrathecal medication utilization guidelines based on literature reviews, physician surveys, and evidence of widespread clinical usage. These guidelines were first published in 2000,5 and updated in 20036 and 2007.7


Intrathecal Morphine Intrathecal Therapy Pump Implantation Intrathecal Space Abdominal Binder 
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We would like to posthumously acknowledge Dr. John C. Oakley as the author of this chapter in the first edition of this book and his influence on the current version of this chapter.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Lisa Jo Stearns
    • 1
  1. 1.Center for Pain and Supportive CareScottsdaleUSA

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