Efficacy of intrathecal drug delivery system for refractory cancer pain patients: A single tertiary medical center experience
Journal
Journal of the Formosan Medical Association
Journal Volume
111
Journal Issue
5
Pages
253-257
Date Issued
2012
Author(s)
Abstract
Background/Purpose: Between 10% and 20% of cancer pain patients fail to obtain adequate pain relief despite comprehensive medical management. The totally implantable programmable intrathecal drug delivery system (IDDS) is an attractive option for managing refractory cancer pain. In suitable patients, IDDS can provide reliable long-term analgesia without any permanent nerve or plexus destruction. IDDS can also allow patient care on an outpatient basis. In Taiwan, however, the experience of using IDDS in terminally ill cancer patients is very limited. Methods: This retrospective study, describes experience of managing totally implantable programmable IDDS in 6 refractory cancer pain patients including patient selection, intraspinal morphine trial, surgical techniques, complications, and drug adjustment. Pain scores and functional status were compared before and after IDDS. Results: By delivering liberal dose of intrathecal morphine, patients' pain scores decreased from 10 to 3.5. Due to much better pain control and improved quality of life, Eastern Cooperative Oncology Group performance status also improved in 4/6 patients. During the mean 5 ± 4.1 months of follow-up, two patients experienced pocket seroma, and resolved spontaneously after short-term abdominal binder compression. Otherwise, no serious complication was noted. Conclusion: Intrathecal morphine delivery by using totally implantable programmable IDDS is an effective method to relieve refractory cancer pain. ? 2012.
Subjects
Analgesia; Analgesics; ECOG; Morphine; Neoplasm; Pain management; Quality of life
SDGs
Other Subjects
morphine; adult; aged; analgesia; article; cancer pain; cancer palliative therapy; clinical article; clinical assessment tool; compression therapy; disease severity; drug delivery system; Eastern Cooperative Oncology Group performance status; female; follow up; human; intrathecal drug delivery system; male; outcome assessment; pain assessment; quality of life; refractory cancer pain; retrospective study; seroma; tertiary health care; Adult; Aged; Analgesics, Opioid; Female; Follow-Up Studies; Humans; Infusion Pumps, Implantable; Infusions, Spinal; Male; Middle Aged; Morphine; Neoplasms; Pain Measurement; Pain, Intractable; Patient Selection; Quality of Life; Retrospective Studies; Treatment Outcome
Type
journal article