OBJECTIVES Intrathecal drug delivery systems represent an important component of interventional strategies for refractory chronic pain syndromes. Continuous intrathecal administration of opioids results in higher subarachnoid drug concentrations, improved pain scores, and less frequent side effects when compared with systemic opioid administration. Substantial costs arise at the time of surgica...

BACKGROUND Intrathecal infusion systems are often used for patients with intractable pain when all else fails, including surgery. There is, however, some concern as to the effectiveness and safety of this treatment. STUDY DESIGN   A systematic review of intrathecal infusion systems for long-term management of chronic non-cancer pain. OBJECTIVE To evaluate and update the effect of intratheca...

BACKGROUND AND OBJECTIVES Epidural and intrathecal techniques are well established for minimizing cancer pain. However, several issues remain unresolved. METHODS A review of studies published in the last 10 years regarding neuraxial techniques in cancer pain management was made. The following issues were assessed: appropriate indications; techniques and delivery systems; conversion from syste...

kappa-opioid receptor agonists (kappa-ORAs) have been shown to modulate visceral nociception through an interaction with a peripheral, possibly novel, kappa-opioid-like receptor. We used in the present experiments an antisense strategy to further explore the hypothesis that kappa-ORA effects in the colon are produced at a site different from the cloned kappa-opioid receptor (KOR). An antisense ...

OBJECTIVE Intrathecal (IT) morphine improves pain control and decreases opioid requirements in children following thoracic and abdominal surgery. However, studies in children report variable durations of analgesia following IT morphine. The purpose of this study is to describe the duration of analgesia in children undergoing surgical correction of idiopathic scoliosis. DESIGN Retrospective ch...

This is the first report showing, in an in vivo study, that systemic morphine produced a marked (89%, P < 0.01) increase of the cholecystokinin octapeptide (CCK-8) immunoreactivity in the perfusate of the rat spinal cord, an effect completely reversed by naloxone. Since CCK-8 has been shown to possess potent anti-opioid activity at a spinal level, a blockade of the spinal cholecystokinin effect...

BACKGROUND Intrathecal (IT) morphine given after a short interval of aortic occlusion in a rodent model induced transient spastic paraparesis via opioid receptor-predicted actions in spinal cord. To determine the role(s) of spinal opioid receptor subtypes we investigated whether IT administration of various selective opioid receptor agonists can induce paraparesis following a short period of sp...

CAN J ANESTH 54: 7 www.cja-jca.org July, 2007 in several muscles. The frequency is usually around 1·sec–1, but may vary from 1–2·min–1 to 600·min–1. The electroencephalogram remains normal.4 Animal studies have demonstrated that the spinal cord can both initiate and maintain myoclonus. The various mechanisms postulated are trauma to the spinal cord with transient subacute spinal neuronitis,2 sp...

Sickle cell anemia is a common genetic disorder in African Americans. Opioid analgesics are traditionally the treatment for the severe pain associated with this disease. Here we reveal that the opioid antagonist naloxone possesses potent analgesic activity in two transgenic mouse models of sickle cell anemia (NY1DD and hBERK1) and not in their respective controls (ICR-CD1 and C57BL/6J) when adm...