Anesth Analg 2005;101:S30-S43
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000177101.99398.22
REVIEW ARTICLES
The Role of Intrathecal Drugs in the Treatment of Acute Pain
James P. Rathmell, MD,
Timothy R. Lair, MD, and
Bushra Nauman, MD
Department of Anesthesiology, University of Vermont College of Medicine, Burlington, Vermont
Address correspondence and reprint requests to James P. Rathmell, M.D., Center for Pain Medicine, Fletcher Allen Health Care, 62 Tilley Drive, South Burlington, VT 05403. Address electronic mail to james.rathmell{at}vtmednet.org.
Intrathecal opioids are widely used as useful adjuncts in the treatment of acute and chronic pain, and a number of non-opioid drugs show promise as analgesic drugs with spinal selectivity. In this review we examine the historical development and current use of intrathecal opioids and other drugs that show promise for treating pain in the perioperative period. The pharmacology and clinical use of intrathecal morphine and other opioids is reviewed in detail, including dosing guidelines for specific surgical procedures and the incidence and treatment of side effects associated with these drugs. Available data on the use of non-opioid drugs that have been tested intrathecally for use as analgesics are also reviewed. Evidence-based guidelines for dosing of intrathecal drugs for specific surgical procedures and for the treatment of the most common side effects associated with these drugs are presented.
This article has been cited by other articles:

|
 |

|
 |
 
G. Andrieu, B. Roth, L. Ousmane, M. Castaner, P. Petillot, B. Vallet, A. Villers, and G. Lebuffe
The Efficacy of Intrathecal Morphine With or Without Clonidine for Postoperative Analgesia After Radical Prostatectomy
Anesth. Analg.,
June 1, 2009;
108(6):
1954 - 1957.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. Meylan, N. Elia, C. Lysakowski, and M. R. Tramer
Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials
Br. J. Anaesth.,
February 1, 2009;
102(2):
156 - 167.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. J. Sheen, S.-T. Ho, C.-H. Lee, Y.-C. Tsung, and F.-L. Chang
Preoperative Gabapentin Prevents Intrathecal Morphine-Induced Pruritus After Orthopedic Surgery
Anesth. Analg.,
June 1, 2008;
106(6):
1868 - 1872.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Xie, J. H. Woods, J. R. Traynor, and M.-C. Ko
The Spinal Antinociceptive Effects of Endomorphins in Rats: Behavioral and G Protein Functional Studies
Anesth. Analg.,
June 1, 2008;
106(6):
1873 - 1881.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
V. L. Ghafoor, M. Epshteyn, G. H. Carlson, D. M. Terhaar, O. Charry, and P. K. Phelps
Intrathecal drug therapy for long-term pain management
Am. J. Health Syst. Pharm.,
December 1, 2007;
64(23):
2447 - 2461.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Parsons
Review: patient controlled opioid analgesia reduces postoperative pain more than conventional as-needed opioid analgesia
Evid. Based Nurs.,
July 1, 2007;
10(3):
83 - 83.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. C. H. Ko, H. Wei, J. H. Woods, and R. T. Kennedy
Effects of Intrathecally Administered Nociceptin/Orphanin FQ in Monkeys: Behavioral and Mass Spectrometric Studies
J. Pharmacol. Exp. Ther.,
September 1, 2006;
318(3):
1257 - 1264.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. C. Rowlingson
Postoperative Pain: To Diversify Is to Satisfy
Anesth. Analg.,
November 1, 2005;
101(5S_Suppl):
S1 - 4.
[Full Text]
[PDF]
|
 |
|
|