Polyanalgesic Consensus Conference—2012: Recommendations to Reduce Morbidity and Mortality in Intrathecal Drug Delivery in the Treatment of Chronic Pain

@article{Deer2012PolyanalgesicCC,
  title={Polyanalgesic Consensus Conference—2012: Recommendations to Reduce Morbidity and Mortality in Intrathecal Drug Delivery in the Treatment of Chronic Pain},
  author={T. Deer and R. Levy and J. Prager and E. Buchser and A. Burton and D. Caraway and M. Cousins and J. De Andr{\'e}s and S. Diwan and Michael Erdek and E. Grigsby and M. Huntoon and Marilyn S. Jacobs and P. Kim and Krishna Kumar and M. Leong and Liong Liem and G. Mcdowell and S. Panchal and R. Rauck and M. Saulino and B. T. Sitzman and P. Staats and M. Stanton-Hicks and L. Stearns and M. Wallace and K. D. Willis and W. Witt and T. Yaksh and N. Mekhail},
  journal={Neuromodulation: Technology at the Neural Interface},
  year={2012},
  volume={15}
}
Introduction:  Targeted intrathecal drug infusion to treat moderate to severe chronic pain has become a standard part of treatment algorithms when more conservative options fail. This therapy is well established in the literature, has shown efficacy, and is an important tool for the treatment of both cancer and noncancer pain; however, it has become clear in recent years that intrathecal drug delivery is associated with risks for serious morbidity and mortality. 
The Polyanalgesic Consensus Conference (PACC): Recommendations for Intrathecal Drug Delivery: Guidance for Improving Safety and Mitigating Risks
  • T. Deer, J. Pope, +16 authors N. Mekhail
  • Medicine
  • Neuromodulation : journal of the International Neuromodulation Society
  • 2017
TLDR
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TLDR
Recommendations to reduce morbidity and mortality in intrathecal drug delivery in the treatment of chronic pain, employing data generated through a literature search, combined with clinical experience – the 2012 Polyanalgesic Consensus Conference are formulated. Expand
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TLDR
This chapter begins with an overview as to how intrathecal therapy can be a useful modality to modulate spinal transmission of pain signals, followed by historical perspectives, indications, contraindications, and current guidelines from the Polyanalgesic Consensus Conference. Expand
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  • T. Deer, J. Pope, +35 authors N. Mekhail
  • Medicine
  • Neuromodulation : journal of the International Neuromodulation Society
  • 2017
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TLDR
Current knowledge regarding intrathecal opioid therapy is reviewed, focusing particularly on the use of IDD in elderly patients, and the arguments in favor of and against this therapy in elderly Patients are discussed. Expand
Advances in intrathecal drug delivery
TLDR
This review includes the recommendations for the use of IDDS, trialing, and recent reports of complications (especially, the occurrence of granulomas), and the latest documents on cerebrospinal fluid and potential lines of future development are discussed. Expand
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TLDR
A stepwise paradigm to implement an intrathecal drug delivery program in the cancer pain population is described and multiple medication combinations may be used to optimize the therapeutic benefit of the device. Expand
Primary Hydromorphone‐Related Intrathecal Catheter Tip Granulomas: Is There a Role for Dose and Concentration?
TLDR
Studies suggest a strong correlation between the use of higher doses and concentrations of intrathecal opiates and ICTG formation and a relatively infrequent, but potentially devastating complication. Expand
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