title: Management of chronic intractable angina - spinal opioids offer an alternative therapy.
abstract: The successful treatment of chronic intractable angina by spinally administered opioids via an Algomed drug delivery device (hereinafter called the pump) is reported in seven patients. All patients had at least two prior cardiac surgeries and the duration of minimally controlled chronic intractable angina varied from 5 to 19 years prior to spinally administered opioids. The duration of effective spinally administered analgesia to either the epidural (two cases) or intrathecal (five cases) spaces varied from 2 to 7 years. The opioid used was either morphine or fentanyl and the dose increase (either mg/year or microg/year, respectively) varied from 1.2 to 16. We suggest that bolus spinal morphine or fentanyl administered via the pump is a viable alternative for the effective control of angina when more established therapies have been found to provide insufficient pain relief.
authors.affiliation: Pain Management Unit, Flinders Medical Centre, Bedford Park, SA 5042, Australia. david.cherry@flinders.edu.au
authors.forename: David A
authors.initials: DA
authors.lastname: Cherry
authors.forename: Geoffrey K
authors.initials: GK
authors.lastname: Gourlay
authors.forename: Karen A
authors.initials: KA
authors.lastname: Eldredge
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D010148:Intractable Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D009294:Narcotics