• Denis Dupoiron, Florent Bienfait, Gabriel Carvajal, Valerie Seegers, Thomas Douillard, Sabrina Jubier-Hamon, Thierry Delorme, Arthur Julienne, Yves Marie Pluchon, Nicolas Ribault, Edmond Nader, and Nathalie Lebrec.
• Anesthesiology and Pain Department, Institut de Cancérologie de l'Ouest, Angers, France denis.dupoiron@ico.unicancer.fr.
• Reg Anesth Pain Med. 2024 Oct 8; 49 (10): 757763757-763.

BackgroundIntrathecal analgesia plays a key role for patients suffering refractory cancer pain. Nevertheless, intrathecal drug delivery systems (IDDS), requiring a cervical catheter tip implantation, have been poorly described in medical literature.AimsA monocentric retrospective follow-up study was designed to evaluate results of cervical IDDS for cancer pain.Patients And MethodsFrom January 2010 to December 2022, all intrathecal-treated patients were prescribed a combined intrathecal analgesics regimen through a catheter placed in the cervical vertebral canal. Post-implant assessment of pain was determined using a numeric rating scale (NRS). Patients were followed via day-hospital visits and telephone calls at least monthly. Pain scores were compared using the Wilcoxon's signed rank test.ResultsNinety-eight patients were included in this study; all received intrathecal treatments. Implanted patients suffered from severe pain (mean presurgical maximum numerical rating score 8.02±0.24 despite a mean 562.56±127.72 mg of oral morphine equivalent daily dose). Mean survival time after intrathecal treatment start was 208.48±67 days. Intrathecal drug delivery systems provided pain relief compared with initial pain score with a significant statistical difference after 1 week, 1 month, 2 and 3 months (p<0.01). A 50% reduction in initial pain level was achieved in 93% of cases during the first week of intrathecal implant.ConclusionsResults suggest that long-term intrathecal treatment using a multidrug regimen for cancer-related pain through cervical intrathecal catheters was suitable and safe in our study population. We demonstrated a clinically and statistically significant pain reduction in patients using mainly a percutaneous lumbar approach.© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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