Intrathecal hydromorphone for intractable nonmalignant pain: a retrospective study.
BACKGROUND
Hydromorphone is often administered intrathecally for the treatment of cancer and nonmalignant chronic intractable pain. It is frequently utilized in combination with other analgesics in a multidrug intrathecal infusion; however, very little data are available documenting efficacy or safety of intrathecal hydromorphone as a solo analgesic.


OBJECTIVE
This study was conducted to examine pain and side effects in patients receiving intrathecal hydromorphone.


METHODS
A retrospective review was conducted of all patients receiving intrathecal hydromorphone monotherapy in two large pain specialty practices in the Pacific Northwest. All data collected within 30 days of the patient's 3-month, 6-month, and 12-month anniversary of implant were analyzed.


METHODS
Twenty-four patients with noncancer-related chronic pain were included in the study. Thirteen patients had eligible pain data at 1 month, 10 patients had pain data at 3 months and seven patients had pain data available at 12 months after initiation of intrathecal hydromorphone.


RESULTS
Average pain scores decreased significantly (P = 0.03). Side-effect and pain-interference scores remained essentially unchanged in this small sample of patients.
Du Pen
Stuart
S
Overlake Pain Medicine Clinic, Overlake Medical Center, Bellevue, Washington 98004, USA. stuart.dupen@overlakehospital.org
Du Pen
Anna
A
Hillyer
Jon
J
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004361:Drug Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage* / Q000009:adverse effects; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects; D010148:Intractable Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D004091:Hydromorphone