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Intrathecal Trialing Techniques for Pain Indications

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Neuraxial Therapeutics

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Abstract

It is required that a trial of medication administration be performed before implanting an intrathecal drug delivery device in the United States. This requirement was not based on strong clinical evidence but rather on tradition, common sense, and insurance payer expectation. Despite the fact that it seems to make sense that a trial before application of treatment would be beneficial, there is mounting evidence to suggest that an intrathecal trial is not predictive of response to therapy, predictive of dose, or even to some extent predictive of side effects. This chapter explores the evidence behind intrathecal trialing, various accepted ways to conduct an intrathecal trial, and the evidence underpinning this practice.

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Authors and Affiliations

  1. University of Kentucky Department of Anesthesiology Division of Pain Medicine, University of Kentucky College of Medicine, Lexington, KY, USA

    Jay S. Grider & Michael E. Harned

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  1. Jay S. Grider
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  2. Michael E. Harned
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Correspondence to Jay S. Grider .

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Editors and Affiliations

  1. (CTF-312), UC San Diego-Anesthesia Res Lab 081 (CTF-312), La Jolla, CA, USA

    Tony Yaksh

  2. University Hospital, Case Western Reserve University, Cleveland, OH, USA

    Salim Hayek

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Grider, J.S., Harned, M.E. (2023). Intrathecal Trialing Techniques for Pain Indications. In: Yaksh, T., Hayek, S. (eds) Neuraxial Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-031-39558-1_28

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