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- Amitabh Gulati, Jeffrey Loh, Vinay Puttanniah, and Vivek Malhotra.
- Department of Anesthesiology & Critical Care, Memorial Sloan-Kettering Cancer Center M308, New York, NY 10065, USA.
- Pain Manag. 2013 Mar 1;3(2):123-8.
AbstractSUMMARY Choosing the initial medications for intrathecal delivery is often confusing and not standardized. We describe a novel way for using a combined spinal-epidural technique to compare two first-line medications for intrathecal delivery; ziconotide and morphine (or hydromorphone). Five patients with intractable chronic or cancer pain were elected to have an intrathecal drug delivery system implanted for pain management. Each patient was given a 3-day inpatient trial with the combined spinal-epidural technique. The Visual Analog Scale, Numerical Rating Scale, short-term McGill questionnaire and opioid consumption were monitored daily. The results were used to develop a paradigm to describe how ziconotide can be used in practice.
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