• David M Schultz, Caitlin H Bakke, Hannah L Ruble, Collin S Larmour, Jonathan M Hagedorn, and Alaa Abd-Elsayed.
• Nura Pain Clinic, Minneapolis MN, USA; Department of Anesthesia, Critical Care and Pain Medicine, University of Minnesota, Twin Cities, MN, USA. Electronic address: dschultz@nuraclinics.com.
• Neuromodulation. 2025 Jan 4.

ObjectivesPast studies have shown the efficacy of spinal targeted drug delivery (TDD) in pain relief, reduction in opioid use, and cost-effectiveness in long-term management of complex chronic pain. We conducted a survey to determine treatment variables associated with patient satisfaction.Materials And MethodsPatients in a single pain clinic who were implanted with Medtronic pain pumps to relieve intractable pain were identified from our electronic health record. From November 2021 to February 2023, 973 patients with active TDD were identified; 564 completed the 23-question survey, and 560 were included in analyses. Most patients (96.4%) had intrathecal (IT) infusion admixtures containing bupivacaine and opioid. The survey compared satisfaction with IT medication dosages, pain relief, pain diagnosis, catheter tip location, side effects, mental clarity, physical functioning, and healthcare utilization. Outcomes were reported as proportions; p < 0.05 was considered significant.ResultsMost respondents reported good-to-excellent pain relief (63.8%), high satisfaction with TDD (80.7%), improvement in physical functioning (75.0%), and better quality of life (89.7%); 78.5% of respondents reported complete discontinuation or substantial reductions in systemic opioid use. There was a statistically significant relationship between satisfaction and IT medication dose (p = 0.02), with the average dose increasing with higher satisfaction groups. We found that patients on higher doses of IT opioids did not have more bothersome side effects (p = 0.05).ConclusionsOur data show that the most satisfied respondents had higher IT doses, fewer side effects, and longer duration of TDD therapy. This suggests that higher dose IT admixtures are safe and effective at relieving pain and improving quality of life in patients with complex chronic pain whose condition has failed to respond adequately to other treatments. TDD may be an effective alternative to long-term systemic opioids for well-selected patients willing to accept the risks of invasive procedures.Copyright © 2024 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

5 keywords...

hide…