Intrathecal Drug Delivery

Intrathecal Baclofen Therapy (ITB) for Treating Spasticity

 

About Intrathecal Drug Delivery

Intrathecal Drug Delivery (IDD) directs prescribed pain medications to the spinal cord—affecting primarily the presynaptic and postsynaptic receptors in the gelatinosa of the posterior horn of the spinal cord. Pain medications delivered directly to the intrathecal space are particularly effective because they don't circulate systemically to reach the cerebrospinal fluid (CSF).

As a result, effective pain relief may be achieved using much smaller doses than are used in orally administered analgesics (for example, approximately 1/300 of an oral morphine dose),1,2 thus reducing the frequency of side effects.

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Watch Intrathecal Drug Delivery Peer Discussions

Patients who are most likely to benefit from Intrathecal Drug Delivery Dr. David L. Caraway, MD, CEO & Medical Director, Center for Pain Relief, Tri-State St. Mary's Regional Medical Center, Huntington, WV speaks about patient selection.

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Indications

Chronic intraspinal (epidural and intrathecal) infusion of preservative-free morphine sulfate sterile solution in the treatment of chronic intractable pain, chronic intrathecal infusion of preservative-free ziconotide sterile solution for the management of severe chronic pain.

Contraindications

When infection is present; when the pump cannot be implanted 2.5 cm or less from the surface of the skin; when body size is not sufficient to accept pump bulk and weight; when contraindications exist relating to the drug; drugs with preservatives.

References

  1. Lamer TJ. Treatment of cancer-related pain: When orally administered medications fail. Mayo Clinical Proc 1994;69:473-80.
  2. Levy, R. Implanted Drug Delivery Systems for Control of Chronic Pain. Chapter 19 of Neurosurgical Management of Pain. New York, NY: Springer-Verlag; 1997.

Treatment & Diagnosis

How Intrathecal Drug Delivery Treats Pain

An estimated 25% of the U.S. population is affected by chronic pain.1 When more conservative therapies have failed, the cost and risks of managing pain rise. Increasingly, many healthcare providers are employing a multi-modal approach to pain that includes intrathecal drug delivery systems.

Implantable intrathecal drug delivery systems are gaining more acceptance as a chronic pain intervention option. Intrathecal drug delivery may provide long-lasting pain relief for patients unresponsive to other therapies. It also may reduce the need for oral analgesics.

Since the introduction of intrathecal drug delivery systems in 1991, more than 150,000 patients worldwide have received a Medtronic drug infusion system to treat chronic pain.

References

  1. Loesser JD, et al. History of Pain Concepts and Therapies. In: Bonica's Management of Pain, 3rd ed. Hagerstown, MD: Lipponcott Williams and Wilkins, 200.