title: Use of an implantable drug delivery system for refractory chronic sickle cell pain.
abstract: An increasing number of chronic sickle cell patients are being treated with sustained-release opioids in the same manner as cancer patients. In a randomized clinical trial of patients with refractory cancer pain, implantable intrathecal drug delivery systems (IDDS) improved clinical success compared to comprehensive medical management alone. We implanted IDDS pumps in two sickle cell patients with refractory bone pain. Both patients achieved rapid and sustained relief of pain, with dramatic reduction in the use of as-needed opioids, crises, and admissions. IDDS may offer relief for sickle cell patients with refractory pain. A prospective trial with more participants is planned.
authors.affiliation: VCU Sickle Cell Anemia Program and Thomas Palliative Care Unit of Virginia Commonwealth University Medical Center, Richmond, VA, USA. tsmith@hsc.vcu.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Coyne
authors.forename: Wally R
authors.initials: WR
authors.lastname: Smith
authors.forename: John D
authors.initials: JD
authors.lastname: Roberts
authors.forename: Virginia
authors.initials: V
authors.lastname: Smith
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D016879:Salvage Therapy
chemical_list: D009294:Narcotics