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 ...

objective: to assess the association between intrapartum intrathecal opioid use and breastfeeding and weight gain following cesarean section. materials and methods: the prospective double-blinded study was conducted on term pregnant women, undergoing elective cesarean section under spinal anesthesia. they divided into two groups. in the first group, intrathecal morphine was used to achieve anal...

Objective. Intrathecal opioid/local anesthetic mixtures are a popular alternative in contemporary treatment of chronic nonmalignant pain. Unfortunately, its use is based solely on retrospective studies or anecdotal reports. Materials and Methods. A double blind, randomized, crossover, multicenter study was performed in 24 patients with intrathecal pumps. For four consecutive months, their pumps...

BACKGROUND Various methods exist for trialing patients for intrathecal drug delivery. Currently no standards exist regarding "best practices" for trialing techniques. OBJECTIVES The specific aim of the current study is to report results of patients trialed using a low-dose intrathecal morphine technique in the treatment of chronic noncancer pain. SETTING academic pain medicine practice ST...

Intraspinal drug delivery (IDD) has been increasingly utilized since 1980s, initially in patients with cancer pain, and subsequently in patients with intractable, chronic, nonmaligmant pain. 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 t...

BACKGROUND The introduction of intrathecal opioid administration for intractable chronic non-malignant pain and cancer pain is considered as one of the most important breakthroughs in pain management. Morphine, the only opioid approved by FDA for intrathecal administration, has been increasingly utilized for this purpose. For over 3 decades, there have been numerous reports on the non-nocicepti...

The exercise pressor reflex is greater in rats with ligated femoral arteries than it is in rats with freely perfused femoral arteries. The exaggerated reflex in rats with ligated arteries is attenuated by stimulation of μ-opioid and δ-opioid receptors on the peripheral endings of thin-fiber muscle afferents. The effect of stimulation of κ-opioid receptors on the exercise pressor reflex is unkno...

BACKGROUND Peripheral tissue injury causes a migration of opioid peptide-containing immune cells to the inflamed site. The subsequent release and action of these peptides on opioid receptors localized on peripheral sensory nerve terminals causes endogenous analgesia. The spinal application of opioid drugs blocks the transmission of nociceptive information from peripheral injury. This study inve...

Spinal intrathecal injections of the nonsteroidal antiinflammatory analgesics (NSAIAs) indomethacin and acetylsalicylic acid, which inhibit prostaglandin synthesis, cause dose-dependent hypoalgesia in the rat. Intrathecal injections of prostaglandin-E2 (PGE2) produce dose-dependent hyperalgesia. To determine whether this action of prostaglandins on the central nervous system is mediated through...

BACKGROUND Intrathecal morphine pre-conditioning attenuates cardiac ischemia-reperfusion injury via activation of central opioid receptors. We hypothesized that intrathecal morphine also post-conditions the myocardium in the rat. METHODS Intrathecal morphine at 0.3 μg/kg (LMPC), 3 μg/kg (MMPC) or 30 μg/kg (HMPC) was administered for 5 min before 120-min reperfusion following 30-min ischemia. ...