Intrathecal Opioid Therapy for Chronic Nonmalignant Pain: A Retrospective Cohort Study with 3-Year Follow-Up

Objective. The objective of this study was the analysis of outcomes after intrathecal opioid treatment. Design. Retrospective chart review cohort study. Setting. Tertiary care university hospital and clinic. Patients. Adults of both sexes were included. Interventions. The intervention consisted of the implantation of intrathecal catheter and subcutaneous programmable pump to deliver opioids. Outcome Measures. These included intrathecal and oral opioid consumption, self-reported pain levels, and complications. Results. We observed reduction of visual analog scale scores, decrease in oral opioid consumption. Stable long-term (3 year) pain reports. We also noted gradual increases in intrathecal opioid consumption. Pre-implant opioid consumption was inversely correlated with treatment success. The complication rate was approximately 20%. Conclusions. We conclude that intrathecal opioids without adjunctive intrathecal medications have a favorable outcome. Some patients are able to eliminate oral opioids. Results seem stable for prolonged periods, although some increase in intrathecal opioids dosing may be required.