BACKGROUND Spinal analgesia, mediated by opioid receptors, requires only a fraction of the opioid dose that is needed systemically. By infusing a small amount of opioid into the cerebrospinal fluid in close proximity to the receptor sites in the spinal cord, profound analgesia may be achieved while sparing some of the side effects due to systemic opioids. Intraspinal drug delivery (IDD) has bee...

BACKGROUND Intrathecal drug infusion therapy is usually considered when spinal-acting analgesics or antispasmodics administered via the oral or transdermal routes fail to control patients' pain or are associated with unacceptable side effects. The intrathecal administration of centrally acting agents bypasses the blood-brain-barrier resulting in much higher cerebrospinal fluid (CSF) concentrati...

BACKGROUND In most patients, cancer pain is effectively treated with conservative medical management consisting of oral and/or transdermal analgesics. Cancer patients tend to fail conservative medical management near the end of their life expectancy, thus requiring alternative routes of analgesia such as intravenous, epidural, or intrathecal. The intrathecal route provides the most effective an...

among patients with chronic unrelieved pain, war veterans of eight years long iraq - iran war deserve especial attention. they not only suffer from severe intractable pain but also should bear some intangible consequences of unrelieved pain and severe disability. this perspective study reviews the outcome of implantation of intrathecal opioid pumps in these patients. ten war veterans (mean age ...

OBJECTIVES This study aimed to investigate the hypothalamic-pituitary-gonadal axis in a sample of male patients undertaking intrathecal opioid delivery for the management of chronic non-malignant pain and the presence of osteopaenia and/or osteoporosis in those diagnosed with hypogonadism. DESIGN Observational study using health data routinely collected for non-research purposes. SETTING De...

A lanthionine enkephalin derivative, Tyr-c[D-ValL-Gly-Phe-DAlaL ]-OH (DVL DAL LanEnk), where ValL and AlaL denote the lanthionine amino acid ends linked via a monosulfide bridge to form the lanthionine structure, was synthesized. It was found to possess selectivity for and potency at the versus opioid receptor as defined by binding studies and by its respective activity on the mouse vas deferen...