Polyanalgesic consensus conference 2003: An update on the management of pain by intraspinal drug delivery - Report of an expert panel

Samuel J. Hassenbusch, Russell K. Portenoy, Michael Cousins, Eric Buchser, Timothy R. Deer, Stuart L. Du Pen, James Eisenach, Kenneth A. Follett, Keith R. Hildebrand, Elliot S. Krames, Robert M. Levy, Pamela P. Palmer, James P. Rathmell, Richard L. Rauck, Peter S. Staats, Lisa Stearns, K. Dean Willis

Research output: Contribution to journalArticlepeer-review

174 Scopus citations


Intraspinal drug infusion using fully implantable pump and catheter systems is a safe and effective therapy for selected patients with chronic pain. The options for this approach are increasing, as drugs that are commercially available for systemic administration are adapted to this use and other drugs that are in development specifically for intraspinal administration become available. In 2000 a Polyanalgesic Consensus Conference was organized to evaluate the existing literature and develop guidelines for drug selection. The major outcome of this effort, an algorithm for drug selection, was based on the best available evidence at the time. Rapid changes have occurred in the science and practice of intraspinal infusion and a Polyanalgesic Consensus Conference 2003 was organized to pursue the following goals: 1) to review the literature on intraspinal drug infusion since 1999, 2) to revise the 2000 drug-selection algorithm, 3) to develop guidelines for optimizing drug dosage and concentration, 4) to create a process for documenting minimum evidence supporting the use of a drug for intraspinal infusion, and 5) to clarify issues pertaining to compounding of drugs. Based on the best available evidence and expert opinion, consensus recommendations were developed in all these areas. The panel's conclusions may provide a foundation for clinical practice and a rational basis for new research.

Original languageEnglish (US)
Pages (from-to)540-563
Number of pages24
JournalJournal of Pain and Symptom Management
Issue number6
StatePublished - Jun 2004
Externally publishedYes


  • Algorithm
  • chronic pain
  • clinical evidence
  • implantable pump
  • intraspinal infusion
  • intrathecal infusion
  • neuraxial infusion
  • polyanalgesic drugs
  • safety and efficacy

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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