Age-dependent Intrathecal Opioid Escalation in Chronic Noncancer Pain Patients

Age-dependent intrathecal opioid escalation in chronic noncancer pain patients.

BACKGROUND Age and gender may exert important influences on opioid responsiveness and chronic pain. These effects have not been explored in the setting of chronic intrathecal (IT) opioid therapy. The objective of this study was to evaluate the effect of age and sex on IT opioid requirements during the first year after implantation of an intrathecal drug delivery system (IDDS) in chronic noncanc...

Combination of intrathecal opioids with bupivacaine attenuates opioid dose escalation in chronic noncancer pain patients.

OBJECTIVE The purpose of this study was to examine the effect of intrathecal (IT) coadministration of bupivacaine with opioids during the initial phase of opioid titration and up to 1 year after implantation of an IT drug delivery system (IDDS). DESIGN The study was designed as a retrospective study. OUTCOMES ANALYZED: The outcomes analyzed for this study were pain relief, oral opioid consump...

Programmable intrathecal opioid delivery systems for chronic noncancer pain: a systematic review of effectiveness and complications.

OBJECTIVES We conducted a systematic review of the literature on the effectiveness and complications of programmable intrathecal opioid and ziconotide drug delivery systems (IDDS) for patients with chronic noncancer pain. METHODS We searched MEDLINE, Cochrane, and other bibliographic databases to identify English-language journal articles reporting programmable IDDS complications or effects o...

A predictive model for intrathecal opioid dose escalation for chronic non-cancer pain.

BACKGROUND Tolerance is defined as a phenomenon in which exposure to a drug results in a decrease of an effect or the requirement of a higher dose to maintain an effect. The fear of a patient developing opioid tolerance contributes regularly to the stigmatization and withholding of intrathecal opioid therapy for chronic pain of non-cancer origin. OBJECTIVES The aim of this study was to descri...

Principles of opioid use in chronic noncancer pain.