Polyanalgesic consensus conference 2012: Recommendations for the management of pain by intrathecal (intraspinal) drug delivery: Report of an interdisciplinary expert panel

Timothy R. Deer, Joshua Prager, Robert Levy, James Rathmell, Eric Buchser, Allen Burton, David Caraway, Michael Cousins, José De Andrés, Sudhir Diwan, Michael Erdek, Eric Grigsby, Marc Huntoon, Marilyn S. Jacobs, Philip Kim, Krishna Kumar, Michael Leong, Liong Liem, Gladstone C.Mc Dowell Ii, Sunil PanchalRichard Rauck, Michael Saulino, B. Todd Sitzman, Peter Staats, Michael Stanton-Hicks, Lisa Stearns, Mark Wallace, K. Dean Willis, William Witt, Tony Yaksh, Nagy Mekhail

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: The use of intrathecal (IT) infusion of analgesic medications to treat patients with chronic refractory pain has increased since its inception in the 1980s, and the need for clinical research in IT therapy is ongoing. The Polyanalgesic Consensus Conference (PACC) panel of experts convened in 2000, 2003, and 2007 to make recommendations on the rational use of IT analgesics based on preclinical and clinical literature and clinical experiences. Methods: The PACC panel convened again in 2011 to update the standard of care for IT therapies to reflect current knowledge gleaned from literature and clinical experience. A thorough literature search was performed, and information from this search was provided to panel members. Analysis of published literature was coupled with the clinical experience of panel members to form recommendations regarding the use of IT analgesics to treat chronic pain. Results: After a review of literature published from 2007 to 2011 and discussions of clinical experience, the panel created updated algorithms for the rational use of IT medications for the treatment of neuropathic pain and nociceptive pain. Conclusions: The advent of new algorithmic tracks for neuropathic and nociceptive pain is an important step in improving patient care. The panel encourages continued research and development, including the development of new drugs, devices, and safety recommendations to improve the care of patients with chronic pain.

Original languageEnglish (US)
Pages (from-to)436-466
Number of pages31
JournalNeuromodulation
Volume15
Issue number5
DOIs
StatePublished - Jan 1 2012

Keywords

  • Chronic pain
  • consensus
  • intrathecal

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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