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IMPLANTABLE INFUSION DEVICES FOR LONG TERM PAIN MANAGEMENTEXAMINATION OF ITS EFFECTIVENESS AGAINST OTHER MEASURESI reviewed 36 available articles up to date in order to answer the above question In my presentation I will start by giving background information about chronic pain I will discuss different types of delivery systems available their benefits to the patient as well as disbenefits and cost Chronic pain reduces the quality of life in many patients and restricts their ability to engage in normal daily activities Although many pain patients may be managed in the long term on oral medications there is percentage of this population that needs additional or alternative means of treatment Many side effects of the medications themselves such as depression drowsiness confusion may contribute to the intractable nature of the problem For the past 18 years administration of opiates by the spinal route has been one of the palliative treatments available for intractable cancer pain or non-malignant pain which is resistant to other methods The goal of the morphine pump is not to deal with the underlying disease but to control the pain symptoms Intrathecal and epidural administration of narcotics relieves pain by stimulation of stereospecific opiate receptors in the spinal cord and brain stem Several types of intraspinal opioid delivery systems are now in use and they are selected based on the patients life expectancy Less than 5 of cancer patients require invasive approaches for the treatment of cancer pain However it is theoretically possible to use these technologies for all chronic pain patients and the market could be enormousPatient management guidelines that were published in 1993 in the Journal of Pain and Symptom Management suggest that patients with cancer related pain who have undergone sequential strong opioid drug trials who have intractable unmanageable side effects and who have undergone a successful spinal opioid efficacy trial and patients with none cancer related chronic pain who failed all conventional syndrome specific therapies before neuroablative surgical procedures
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