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KMID : 1150120150010010024
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Asian Journal of Pain
2015 Volume.1 No. 1 p.24 ~ p.29
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Programmable Intrathecal Morphine Pump for the Management of Chronic Pain
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Oh Hyung-Sug
Oh Han-San
Park Kwan-Ho
Kim Tae-Wan
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Abstract
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There are a variety of options for the treatment of chronic pain. Oral medications include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, antidepresssants, anticonvulsants and opioids. Common side effects of opioid administration are sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance and respiratory depression. There are interventional techniques that involve injections into or around various levels of the spinal region. Intrathecal drug delivery systems (IDDS) for the treatment of pain is a modulator of nociceptive signal transmission to and within the central nervous system. IDDS consist of a pump and catheter, both of which are surgically placed under the skin. The implantable pump that stores and delivers medication through a catheter to the intrathecal (IT) space. IDDS has become one of the most innovating procedures in treating pain. Programming by external programmer over the implanted pump change the mode of drug delivery. They have the advantage of reduced oral or parenteral medication doses, side effects of long-term use, and a lower risk of infection. Clinician choose IDDS as a final method to relieve intractable pain. Morphine is the only opioid approved by FDA for IT administration and has been increasingly utilized for this purpose. Implantable IT morphine pump has become a common option for administering opiate medication for refractory chronic pain. Clinician should be aware of patient selection, surgical techniques, mechanical, pharmacological, and patient-specific complications.
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KEYWORD
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Intrathecal drug delivery systems, Chronic pain, Morphine pump
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