title: Trialing and Maintenance Dosing Using a Low-Dose Intrathecal Opioid Method for Chronic Nonmalignant Pain: A Prospective 36-Month Study.
abstract: OBJECTIVE
  To evaluate low-dose intrathecal opioid trialing and maintenance with regard to analgesia and psychometric functional capacity.
  
  
  METHODS
  Prospective cohort of subjects offered, trialed and maintained using low-dose opioid therapy via an intrathecal drug delivery system. Analgesia, measured by visual analog scale and the Global Pain Scale, and function, measured by Multidimensional Pain Inventory and Global Pain Scale, are evaluated. Population analysis by age, gender, oral opioid dose, diagnosis, and pain type is reported.
  
  
  RESULTS
  Fifty-eight subjects enrolled in the 36-month evaluation period with mean opioid intrathecal opioid dose less than 350 μg per day of morphine equivalent utilized. Primary nociceptive pain type were associated with lower intrathecal opioid doses and improved visual analog scale pain rating and improved pain severity and interference on the Multidimensional Pain Inventory.
  
  
  CONCLUSIONS
  This study adds to the growing body of literature suggesting that low-dose intrathecal analgesia without oral opioid supplementation can be efficacious. It appears that this approach may achieve analgesia with lower doses in those with primary nociceptive pain type.
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Grider
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Etscheidt
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Harned
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Smith
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Lamar
authors.affiliation: Pain Medicine, Danville Anesthesia Associates, Danville, KY, USA.
authors.forename: Anjum
authors.initials: A
authors.lastname: Bux
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D059350:Chronic Pain / Q000628:therapy; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid
keywords: Chronic benign pain; intrathecal drug delivery; intrathecal opioids; oral opioid therapy