BACKGROUND In 2006, the authors observed a cluster of three deaths, which circumstances suggested were opioid-related, within 1 day after placement of intrathecal opioid pumps for noncancer pain. Further investigation suggested that mortality among such patients was higher than previously appreciated. The authors performed investigations to quantify that mortality and compare the results to con...

A preliminary study is reported on the kinetics of meptazinol following intrathecal and i.m. administration in the Patas monkey. Following intrathecal administration (single dose of 0.5 mg) at T12/L1, meptazinol rapidly disappeared from the CSF with a T1/2 of 35 min. At 240 min after intrathecal injection, most of the meptazinol had been distributed within the spinal tissue near the region of t...

BACKGROUND The efficacy of opioids for neuropathic pain remains controversial. The effects of morphine on pain behavior were investigated in two animal models of neuropathic pain: the spared nerve injury (SNI) model and the spinal nerve ligation (SNL) model. METHODS Nerve injuries were created in rats either by tight ligation and section of the left tibial and common peroneal nerves (SNI) or ...

Adding morphine to intrathecal bupivacaine provides sound analgesia, but is associated with side effects. The purpose of this study is to investigate if the contribution of intrathecal morphine to postoperative analgesia for total hip replacement outweighs its side effects in a modern multimodal setting. From November 2012 till January 2013 patients undergoing total hip arthroplasty (THA) under...

Pentobarbital administered intracerebroventricularly to mice has been shown previously to inhibit the analgesic action of morphine given intrathecally. The purpose of the present study was to examine the proposal that this antianalgesic action was mediated spinally by cholecystokinin. First, intrathecal coadministration of cholecystokinin-B sulfate (CCK8s) with morphine inhibited the analgesic ...

Purpose of review The purpose of this review was to discuss therapeutic manipulations and effective current interventions available to treat intravascular lymphoma in the central nervous system. Recent findings Patients experienced resolution and remission of disease for 14 months and up to 2 years after eight cycles of R-CHOP and four courses of intrathecal therapy with MTX, cytarabine, and pr...

Intrathecal opioids are widely used as useful adjuncts in the treatment of acute and chronic pain, and a number of non-opioid drugs show promise as analgesic drugs with spinal selectivity. In this review we examine the historical development and current use of intrathecal opioids and other drugs that show promise for treating pain in the perioperative period. The pharmacology and clinical use o...