Managing intractable pain with an intrathecal catheter and injection port: technique and guidelines.
The objective of our study was to describe an effective technique for the management of chronic intractable pain in patients with intermediate life expectancy or as a long-term screening device prior to implantable pump therapy. In the study, an InDura intraspinal catheter is connected to a BardPort, which is accessed transdermally. We describe our surgical technique, recommended dosage calculations, cost comparison to an implantable infusion pump, and our experience with 13 cases. In our series of 13 patients, there was one seroma and one dural leak. There were no infections, and all were functioning well in the 12 cancer patients until their deaths. One case was converted to an implantable pump. There were no malfunctions or infections of the intrathecal infusion system in the 12 cancer patients. This intrathecal drug infusion system should be considered in the treatment armamentarium for chronic intractable pain and cancer pain.
Meenan
D
D
Department of Anesthesia, Temple University/Conemaugh's Memorial Medical Center, Johnstown, Pennsylvania 15905, USA.
Lagares-Garcia
J A
JA
Kurek
S
S
Craig
D
D
Green
J
J
Fritz
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000191:economics; D003365:Costs and Cost Analysis; D016503:Drug Delivery Systems / Q000191:economics; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D009369:Neoplasms / Q000150:complications; D010148:Intractable Pain / Q000191:economics / Q000209:etiology / Q000628:therapy*
D009294:Narcotics