Polyanalgesic Consensus Conference 2007: Recommendations for the management of pain by intrathecal (intraspinal) drug delivery: Report of an interdisciplinary expert panel

Timothy Deer, Elliot S. Krames, Samuel J. Hassenbusch, Allen Burton, David Caraway, Stuart Dupen, James Eisenach, Michael Erdek, Eric Grigsby, Phillip Kim, Robert Levy, Gladstone McDowell, Nagy Mekhail, Sunil Panchal, Joshua Prager, Richard Rauck, Michael Saulino, Todd Sitzman, Peter S. Staats, Michael Stanton-HicksLisa Stearns, K. Dean Willis, William Witt, Kenneth Follett, Marc Huntoon, Leong Liem, James Rathmell, Mark Wallace, Eric Buchser, Michael Cousins, Anne Ver Donck

Research output: Contribution to journalReview articlepeer-review

192 Scopus citations

Abstract

Background. Expert panels of physicians and nonphysicians in the field of intrathecal therapies convened in 2000 and 2003 to make recommendations for the rational use of intrathecal analgesics based on the preclinical and clinical literature known up to those times. An expert panel of physicians convened in 2007 to update previous recommendations and to form guidelines for the rational use of intrathecal opioid and nonopioid agents. Methods. A review of preclinical and clinical published relevant studies from 2000 to 2006 was undertaken and disseminated to a convened expert panel of physicians and nonphysicians. Focused discussions were held on the rational use of intrathecal agents and a survey asking questions regarding intrathecal therapies management was given to the panelists. Results. The panelists, after review of the literature from 2000 to 2006 and discussion, created an updated algorithm for the rational use of intrathecal opioid and nonopioid agents in patients with nonmalignant and end-of-life pain. Of note is that the panelists felt that ziconotide, based on new and relevant literature and experience, should be updated to a line one intrathecal drug.

Original languageEnglish (US)
Pages (from-to)300-328
Number of pages29
JournalNeuromodulation
Volume10
Issue number4
DOIs
StatePublished - Oct 2007
Externally publishedYes

Keywords

  • Analgesics
  • Consensus
  • Guidelines
  • Intrathecal
  • Polyanalgesia

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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