Polyanalgesic Consensus Conference 2012: Recommendations for the Management of Pain by Intrathecal (Intraspinal) Drug Delivery: Report of an Interdisciplinary Expert Panel

被引：185

作者：

Deer, Timothy R. ^{[1
]}

Prager, Joshua ^{[2
]}

Levy, Robert ^{[3
]}

Rathmell, James ^{[4
,5
]}

Buchser, Eric ^{[6
,7
]}

Burton, Allen ^{[8
]}

Caraway, David ^{[9
]}

Cousins, Michael ^{[10
]}

De Andres, Jose ^{[11
,12
]}

Diwan, Sudhir ^{[13
,14
]}

Erdek, Michael ^{[15
,16
,17
]}

Grigsby, Eric ^{[18
,39
]}

Huntoon, Marc ^{[19
]}

Jacobs, Marilyn S. ^{[2
]}

Kim, Philip ^{[20
,21
]}

Kumar, Krishna ^{[22
]}

Leong, Michael ^{[23
]}

Liem, Liong ^{[24
]}

McDowell, Gladstone C., II ^{[25
]}

Panchal, Sunil ^{[26
]}

Rauck, Richard ^{[27
,28
]}

Saulino, Michael ^{[29
,30
]}

Sitzman, B. Todd ^{[31
]}

Staats, Peter ^{[32
]}

Stanton-Hicks, Michael ^{[33
]}

Stearns, Lisa ^{[34
]}

Wallace, Mark ^{[35
]}

Willis, K. Dean ^{[36
,37
]}

Witt, William ^{[38
]}

Yaksh, Tony ^{[35
]}

Mekhail, Nagy ^{[33
]}

机构：

[1] Ctr Pain Relief, Charleston, WV 25301 USA

[2] Univ Calif Los Angeles, Los Angeles, CA USA

[3] Univ Florida, Jacksonville, FL USA

[4] Massachusetts Gen Hosp, Boston, MA 02114 USA

[5] Harvard Univ, Sch Med, Boston, MA USA

[6] CHUV Univ Hosp, Lausanne, Switzerland

[7] EHC Hosp, Anaesthesia & Pain Management Dept, Morges, Switzerland

[8] Houston Pain Associates LLC, Houston, TX USA

[9] Tri State LLC, Ctr Pain Relief, Huntington, WV USA

[10] Royal N Shore Hosp, Kolling Inst Med Res, Sydney, NSW, Australia

[11] Univ Valencia, Sch Med, Valencia, Spain

[12] Gen Univ Hosp, Valencia, Spain

[13] Suny Downstate Med Ctr, Staten Isl, NY USA

[14] Univ Hosp, New York, NY USA

[15] Johns Hopkins Univ, Sch Med, Dept Anesthesiol, Baltimore, MD USA

[16] Johns Hopkins Univ, Sch Med, Dept Crit Care Med, Baltimore, MD USA

[17] Johns Hopkins Univ, Sch Med, Dept Oncol, Baltimore, MD 21205 USA

[18] Napa Pain Inst, Napa, CA USA

[19] Vanderbilt Univ, Nashville, TN USA

[20] Christiana Hosp, Newark, DE USA

[21] Bryn Mawr Hosp, Bryn Mawr, PA USA

[22] Univ Saskatchewan, Regina, SK, Canada

[23] Stanford Univ, Palo Alto, CA 94304 USA

[24] St Antonius Hosp, Nieuwegein, Netherlands

[25] Integrated Pain Solut, Columbus, OH USA

[26] Natl Inst Pain, Lutz, FL USA

[27] Carolinas Pain Inst, Winston Salem, NC USA

[28] Wake Forest Univ, Sch Med Baptist Hlth, Winston Salem, NC 27109 USA

[29] Thomas Jefferson Univ, Jefferson Med Coll, MossRehab, Philadelphia, PA 19107 USA

[30] Thomas Jefferson Univ, Jefferson Med Coll, Dept Rehabil Med, Philadelphia, PA 19107 USA

[31] Adv Pain Therapy PLLC, Hattiesburg, MS USA

[32] Premier Pain Management Ctr, Shrewsbury, NJ USA

[33] Cleveland Clin, Dept Pain Management, Cleveland, OH 44106 USA

[34] Ctr Pain & Support Care, Phoenix, AZ USA

[35] Univ Calif San Diego, La Jolla, CA 92093 USA

[36] Univ Alabama Birmingham, Sch Nursing, Birmingham, AL USA

[37] Alabama Pain Ctr, Huntsville, AL USA

[38] Univ Kentucky, Lexington, KY USA

[39] Neurovat Clin Res & Educ, Napa, CA USA

来源：

NEUROMODULATION | 2012年 / 15卷 / 05期

关键词：

Chronic pain; consensus; intrathecal; SPINAL-CORD-INJURY; SPASTIC CEREBRAL-PALSY; CHRONIC NONCANCER PAIN; IMPLANTABLE INFUSION SYSTEM; BACLOFEN PUMP IMPLANTATION; CEREBROSPINAL-FLUID FLOW; CATHETER TIP GRANULOMAS; D-ASPARTATE ANTAGONISTS; TRAUMATIC BRAIN-INJURY; LONG-LASTING ALLODYNIA;

D O I：

10.1111/j.1525-1403.2012.00476.x

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

100103 [病原生物学]; 100218 [急诊医学];

摘要：

Introduction: The use of intrathecal (IT) infusion of analgesic medications to treat patients with chronic refractory pain has increased since its inception in the 1980s, and the need for clinical research in IT therapy is ongoing. The Polyanalgesic Consensus Conference (PACC) panel of experts convened in 2000, 2003, and 2007 to make recommendations on the rational use of IT analgesics based on preclinical and clinical literature and clinical experiences. Methods: The PACC panel convened again in 2011 to update the standard of care for IT therapies to reflect current knowledge gleaned from literature and clinical experience. A thorough literature search was performed, and information from this search was provided to panel members. Analysis of published literature was coupled with the clinical experience of panel members to form recommendations regarding the use of IT analgesics to treat chronic pain. Results: After a review of literature published from 2007 to 2011 and discussions of clinical experience, the panel created updated algorithms for the rational use of IT medications for the treatment of neuropathic pain and nociceptive pain. Conclusions: The advent of new algorithmic tracks for neuropathic and nociceptive pain is an important step in improving patient care. The panel encourages continued research and development, including the development of new drugs, devices, and safety recommendations to improve the care of patients with chronic pain.

引用

页码：436 / 466

页数：31

共 283 条

[1]

Spinal granuloma in a patient receiving a spinal infusion of morphine and clonidine [J].