Presented at the 2012 AAPM Annual Meeting « Back

Patient Selection and Outcomes Using Low-Dose Intrathecal Opioid Trialing for Chronic Nonmalignant Pain: 24-Month Follow-Up

Jay S. Grider, PhD DO, jsgrid2@email.uky.edu, University of Kentucky, Lexington, Kentucky

Introduction: We have recently described a method of trialing candidates for intrathecal therapy using a low-dose opioid method. (1) The current study represents the 12-month follow-up to that initial observational cohort of patients. Methods: This review was conducted under IRB approval as an ongoing observational cohort of 21 consecutive patients age 38–82 trialed, implanted, and maintained on a low-dose intrathecal morphine protocol provided by an implanted intrathecal drug delivery system. The 21 original subjects were evaluated at 24 months for ongoing analgesia and dose escalation. Visual analog pain scores (VAS) and intrathecal opioid doses were evaluated as one group with average time of implant being 23 months. Results: At 24 months the 21 original subjects had VAS scores of 4.9 +/- SD 2.8 (range 0-10). The average daily dose 348 mcg per day of intrathecal morphine at 12 months following the previous report compared to the initial 12-month period dose reported as 335 mcg per day of intrathecal morphine. (1) 18 of the 21 subjects rated ongoing analgesia as acceptable. Discussion: The previously reported analgesia provided by low-dose intrathecal morphine was consistent and stable at 24 months follow-up. While there was a small in average VAS over the 12 intervening month period however most subjects reported improved quality of life. There were no differences in the reported daily dosage of intrathecal morphine with length of implantation suggesting that subjects were stabilized utilizing the low-dose intrathecal morphine approach. References: 1)1) Grider JS, Harned ME and Etscheidt MA. Patient Selection and Outcomes Using a Low-Dose Intrathecal Opioid Trialing Method for Chronic Nonmalignant Pain. Pain Physician 14:343-351, 2011

Funding: None