title: Intrathecal opioid therapy for chronic nonmalignant pain: a retrospective cohort study with 3-year follow-up.
abstract: OBJECTIVE
  The objective of this study was the analysis of outcomes after intrathecal opioid treatment. Design. Retrospective chart review cohort study. Setting. Tertiary care university hospital and clinic. Patients. Adults of both sexes were included. Interventions. The intervention consisted of the implantation of intrathecal catheter and subcutaneous programmable pump to deliver opioids.
  
  
  METHODS
  These included intrathecal and oral opioid consumption, self-reported pain levels, and complications.
  
  
  RESULTS
  We observed reduction of visual analog scale scores, decrease in oral opioid consumption. Stable long-term (3 year) pain reports. We also noted gradual increases in intrathecal opioid consumption. Pre-implant opioid consumption was inversely correlated with treatment success. The complication rate was approximately 20%.
  
  
  CONCLUSIONS
  We conclude that intrathecal opioids without adjunctive intrathecal medications have a favorable outcome. Some patients are able to eliminate oral opioids. Results seem stable for prolonged periods, although some increase in intrathecal opioids dosing may be required.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington 98195, USA.
authors.forename: Aysel
authors.initials: A
authors.lastname: Atli
authors.forename: Brian R
authors.initials: BR
authors.lastname: Theodore
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Turk
authors.forename: John D
authors.initials: JD
authors.lastname: Loeser
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid