scholarly journals Longevity and Cost of Implantable Intrathecal Drug Delivery Systems for Chronic Pain Management: A Retrospective Analysis of 365 Patients

2014 ◽  
Vol 18 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Robert Bolash ◽  
Belinda Udeh ◽  
Youssef Saweris ◽  
Maged Guirguis ◽  
Jarrod E. Dalton ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Pain Management ◽  
Retrospective Analysis ◽  
Drug Delivery Systems ◽  
Delivery Systems ◽  
Chronic Pain Management ◽  
Intrathecal Drug Delivery

scholarly journals Pancreatic Cancer Related Pain: Review of Pathophysiology and Intrathecal Drug Delivery Systems for Pain Management

2021 ◽  
pp. E583-E594
Keyword(s):  
Quality Of Life ◽  
Drug Delivery ◽  
Pancreatic Cancer ◽  
Pain Management ◽  
Cancer Pain ◽  
Drug Delivery Systems ◽  
Delivery Systems ◽  
Narrative Review ◽  
Intrathecal Drug Delivery

BACKGROUND: Pancreatic cancer (PC) is one of the most lethal cancers and is the eleventh most common cancer worldwide. This disease is characterized by an often-fatal evolution and a high burden of symptoms, particularly pain. Several studies have demonstrated that pancreatic cancer patients have a high prevalence of pain, with up to 82% of patients reporting pain, often requiring systemic strong opioids as mainstay treatment. This comprehensive review of pancreatic cancer related pain (PCRP), focuses on current mechanisms that lead to pain including regional invasion processes, as well as the local secretion of factors that sensitize nociceptive nerves. OBJECTIVE: Our objective was to conduct a review of PCRP and provide updates on intrathecal drug delivery in PC therapeutic recommendations. STUDY DESIGN: We used a narrative review design. We present a novel perspective in the field of pain research by converging data from intrathecal drug delivery trials with previous elements of molecular pain research in PCRP. METHODS: The literature review relating to PCRP pathophysiology and intrathecal drug delivery systems (IDDS) was done with searches of English, French, and Spanish abstracts, using PubMed, Dynamed, EMBASE, SciELO, Uptodate, Google Scholar, and manual searches of the bibliographies of known primary and review articles from IDDS inception until August 2020. Different search strings based on MESH terms were used including: pain, chronic pain, cancer pain, prevalence, pathophysiology, pancreatic cancer, analgesia, invasive pain procedures, celiac plexus neurolysis, pancreatic neuropathy, intrathecal drug delivery, or a combination of these terms. A narrative review based on these sources was prepared. RESULTS: This paper reviews aspects related to pancreatic adenocarcinoma and PCRP prevalence and focuses on recent developments in pathophysiology with IDDS as a pain management strategy. We summarize the best available evidence regarding intrathecal therapy (IT) for PCRP management; 18 studies of IDDS including at least 236 PC patients are analyzed. LIMITATIONS: Some limitations include: IDDS studies heterogeneity regarding disease stage, patient population, and technical aspects, such as catheter placement and treatment regimen, do not allow integration of studies. CONCLUSION: This review analyzes both past and current literature with a critical analysis of findings and respective recommendations. Most studies of IDDS in PCRP evaluate outcomes on pain using one-dimensional pain scales, such as VAS. Other relevant results, such as performance status or quality of life, are not frequently reported. Burden of disease variables, such as cancer stage, location, and comorbidities, like depression and systemic analgesia co-prescription, are usually not presented in these studies. In the same way, most studies do not precisely inform IDDS titration and IT medication. These factors make integration of IDDS in PC studies difficult. Future studies regarding impact of IDDS on pain control on quality of life, in this particular population, may help clinicians in deciding the optimal time and approach for IDDS. The studies should report data on particular disease, comorbidities, and treatment regimens. KEY WORDS: Adenocarcinoma, cancer pain, pain, pancreatic carcinoma, pancreatic neoplasms, pain management, physiopathology, prevalence

Intrathecal drug delivery for chronic pain management-scope, limitations and future

2014 ◽  
Vol 29 (2) ◽  
pp. 241-249 ◽  
Author(s):  
M. Czernicki ◽  
G. Sinovich ◽  
I. Mihaylov ◽  
B. Nejad ◽  
S. Kunnumpurath ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Pain Management ◽  
Intrathecal Drug Delivery

scholarly journals Use of Color Flow Doppler Ultrasonography to Increase the Safety of Intrathecal Drug Delivery System Refills

2019 ◽  
pp. 173-177
Author(s):  
Ankur D. Mehta
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Doppler Ultrasonography ◽  
Delivery Systems ◽  
Ultrasound Images ◽  
Common Procedure ◽  
Color Flow ◽  
Intrathecal Drug Delivery ◽  
Flow Leak

Intrathecal drug delivery systems are effective tools in the treatment of chronic pain or spasticity. Using intrathecal drug delivery systems, drugs are directly infused into the cerebrospinal fluid and gain access to critical receptors in the central nervous system. This delivery method allows for the use of markedly reduced doses of medications to produce the same effects as seen with higher orally administered doses. Reduced dosing produces fewer side effects, creating a more favorable treatment course for patients already suffering from chronic pain or spasticity. Complications with intrathecal drug delivery systems can occur during both the implantation process and the postoperative maintenance of the device. The most common procedure carried out during postoperative maintenance of these devices is the intrathecal pump refill. This procedure must be performed by experienced practitioners in a systematic way in order to prevent complications. The most dreaded of these complications is inadvertent injection of medication into the subcutaneous space as opposed to into the device, commonly referred to as a “pocket fill.” This paper describes and recommends the routine use of color flow doppler ultrasonography as an easy, safe, and effective tool to reduce the chance of a catastrophic “pocket fill.” Routine utilization of live color flow ultrasound guidance during pump refills allows the practitioner to carefully document flow of medication into the pump under the silicone septum. It also allows for demonstration of no leakage from, or fluid increase superficial to, the septum. Additionally, 2 ultrasound images are obtained to document color flow deep to the septum and no color flow/leak/fluid superficial to the septum. Although this complication is rare, it can lead to severe complications including oversedation, respiratory depression, and death. As such, we believe that the utilization of color phase doppler ultrasonography could further reduce this incidence. Key words: Analgesics, opioids, chronic pain, drug overdose, infusion pumps, implantable, injections, spinal, medication errors, spasticity, ultrasonics, methods, ultrasonography, interventional

A Two-Liquid Electroosmotic Pump for Portable Drug Delivery Systems

2007 ◽  
Author(s):  
Shawn Litster ◽  
Byunghang Ha ◽  
Daejoong Kim ◽  
Juan G. Santiago
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Drug Dosage ◽  
Delivery Systems ◽  
Chronic Pain Management ◽  
Patient Mobility ◽  
Infusion Pumps ◽  
Electroosmotic Pump ◽  
Improve Patient

Portable drug delivery systems present an opportunity to improve patient mobility and reduce drug dosage. Infusion pumps for drug delivery are heavily used in hospital and home care settings to administer a variety of therapies such as chemotherapy, antimicrobials, analgesia, anesthesia, and post-operative and chronic pain management. We are developing electroosmotic (EO) pumps for drug delivery applications. EO pumps offer active dosage control, are compact, use low power, and have no moving parts. We here explore a two-liquid EO pump that decouples the drug from the working electrolyte with a series of collapsible membranes and enables EO pumping of a wide variety of medications.

Physician Guidance on the Use of Off‐Labeled Drugs in Intrathecal Drug Delivery Systems for Chronic Pain

2019 ◽  
Vol 22 (7) ◽  
pp. 765-768
Author(s):  
Timothy Deer ◽  
Phillip Kim ◽  
Jason E. Pope ◽  
Salim Hayek ◽  
Gladstone McDowell ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Chronic Pain ◽  
Drug Delivery Systems ◽  
Delivery Systems ◽  
Intrathecal Drug Delivery
Sign in / Sign up

Export Citation Format

Share Document