Long-term intrathecal administration of midazolam and clonidine

Objective: To determine the clinical usefulness of the long-term intrathecal administration of midazolam and clonidine in patients with refractory neurogenic and musculoskeletal pain. Setting: Pain Centre, Academic Hospital Groningen, Groningen, The Netherlands. Patients: Four patients with chronic benign neurogenic and musculoskeletal pain, not responding to conventional analgesic therapy. Outcome measures: Visual Analogue Score, Activities of Daily Living. Results: The intrathecal administration of midazolam and clonidine produced almost immediate and nearly complete pain relief. Even with continuous use, tolerance seemed to be no problem, and side effects appear to be minimal. Conclusion: Intrathecal infusion of midazolam and clonidine produced promising results in four patients with refractory chronic benign pain. Further research will be necessary to determine the efficacy and the risk-to-benefit ratio of long-term administration of this combination.