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https://www.neurologyadvisor.com/topics/pain/updated-guidelines-on-intrathecal-therapy-for-pain/
Jan 19, 2017 · Educational Requirements for Implanting and/or Managing Intrathecal Drug Delivery System Therapy. Consensus points 26 and 27: The PACC recommends that physicians in training, nurses, and allied healthcare professionals receive an overview of IT delivery as part of their core training curriculum.
http://www.britishpainsociety.org/static/uploads/resources/files/itdd_2015_pro_v3.pdf
Delivery of the drug by the intrathecal (spinal) route is a means of achieving enhanced therapeutic effects. The smaller doses needed for intrathecal administration also allow a reduction in side effects compared to systemic administration. There is evidence to support this technique.
http://paccguidelines.cmeoutfitters.com/Home.html
Intrathecal pain management continues to evolve. The 2017 Polyanalgesic Consensus Conference (PACC) Guidelines were developed to meet a growing need for updated guidance to keep pace with emerging evidence, changes in patient care, and to fill current gaps in clinical practice.
https://www.asra.com/page/223/intrathecal-dosing-and-medication-selection
The current intrathecal drug delivery systems (IDDS) are approved by the Food and Drug Administration (FDA) for administration of a single agent and there are only 3 FDA approved agents: baclofen for spasticity and morphine and ziconotide for pain.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227625/
Nov 06, 2014 · Indications for intrathecal drug delivery and patient selection criteria. There are no universally accepted guidelines or recommendations for patient selection. In general, patient selection for IDDS therapy can be divided into cancer and noncancer pain.
http://www.sciencepublishinggroup.com/journal/paperinfo?journalid=257&doi=10.11648/j.ijacm.20200801.15
Intrathecal drug delivery systems (IDDS) have been a valuable therapeutic modality in the treatment of intractable chronic pain, typically reserved for cases where conservative pain management has failed. Given the high risk of this treatment and infrequent encounters with IDDS, it is essential to develop an institutional process to ensure the safe and effective management of patients.
https://www.fda.gov/medical-devices/safety-communications/use-caution-implanted-pumps-intrathecal-administration-medicines-pain-management-fda-safety
Nov 14, 2018 · U.S. Food and Drug Administration ... Intrathecal delivery of medication with an implanted pump for pain management is often reserved for patients who fail other treatment options ...
http://rsds.org/wp-content/uploads/2015/02/Deer_PainPhysician_2010.pdf
These consensus guidelines are intended to assist with weighing this risk/benefit ratio of intrathecal therapy, thereby minimizing the potential for treatment failure, unacceptable adverse effects, and excess mortality. Key words: Chronic pain, noncancer pain, opioids, intrathecal drug delivery systems, guidelines, consensus guidelines
https://www.ncbi.nlm.nih.gov/pubmed/28042904
RESULTS: The PACC has developed an algorithmic process for several aspects of intrathecal drug delivery to promote safe and efficacious evidence-based care. Consensus opinion, based on expertise, was used to fill gaps in evidence. Thirty-one consensus points emerged from the panel considerations.Author: Timothy R. Deer, Jason E. Pope, Salim M. Hayek, Anjum Bux, Eric Buchser, Sam Eldabe, Jose A. De Andr...
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