Polyanalgesic Consensus Conference—2012: Recommendations to Reduce Morbidity and Mortality in Intrathecal Drug Delivery in the Treatment of Chronic Pain
| Autor: | Michael A. Erdek, William W. Witt, Jose De Andres, Marilyn S. Jacobs, Eric Buchser, Nagy Mekhail, Krishna Kumar, Eric Grigsby, Liong Liem, Allen W. Burton, Michael Saulino, Joshua P. Prager, Michael Stanton-Hicks, Richard Rauck, B. Todd Sitzman, Sudhir Diwan, Marc A. Huntoon, Robert M. Levy, Gladstone C. McDowell, Michael S. Leong, K. Dean Willis, Mark S. Wallace, Michael J. Cousins, Lisa Stearns, Philip Kim, Sunil Panchal, Tony L. Yaksh, Peter S. Staats, David Caraway, Timothy R. Deer |
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| Rok vydání: | 2012 |
| Předmět: |
Analgesics
medicine.medical_specialty Intrathecal therapy business.industry Incidence (epidemiology) Chronic pain Consensus conference Drug infusion Infusion Pumps Implantable General Medicine medicine.disease Intrathecal Drug Delivery Systems Anesthesiology and Pain Medicine Neurology Drug delivery Humans Medicine Neurology (clinical) Chronic Pain business Intensive care medicine Injections Spinal Depression (differential diagnoses) |
| Zdroj: | Neuromodulation: Technology at the Neural Interface. 15:467-482 |
| ISSN: | 1094-7159 |
| DOI: | 10.1111/j.1525-1403.2012.00486.x |
| Popis: | Introduction: Targeted intrathecal drug infusion to treat moderate to severe chronic pain has become a standard part of treatment algorithms when more conservative options fail. This therapy is well established in the literature, has shown efficacy, and is an important tool for the treatment of both cancer and noncancer pain; however, it has become clear in recent years that intrathecal drug delivery is associated with risks for serious morbidity and mortality. Methods: The Polyanalgesic Consensus Conference is a meeting of experienced implanting physicians who strive to improve care in those receiving implantable devices. Employing data generated through an extensive literature search combined with clinical experience, this work group formulated recommendations regarding awareness, education, and mitigation of the morbidity and mortality associated with intrathecal therapy to establish best practices for targeted intrathecal drug delivery systems. Results: Best practices for improved patient care and outcomes with targeted intrathecal infusion are recommended to minimize the risk of morbidity and mortality. Areas of focus include respiratory depression, infection, granuloma, device-related complications, endocrinopathies, and human error. Specific guidance is given with each of these issues and the general use of the therapy. Conclusions: Targeted intrathecal drug delivery systems are associated with risks for morbidity and mortality that can be devastating. The panel has given guidance to treating physicians and healthcare providers to reduce the incidence of these problems and to improve outcomes when problems occur. |
| Databáze: | OpenAIRE |
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