• Timothy R Deer, Joshua Prager, Robert Levy, Allen Burton, Eric Buchser, David Caraway, Michael Cousins, José De Andrés, Sudhir Diwan, Michael Erdek, Eric Grigsby, Marc Huntoon, Marilyn Jacobs, Phillip Kim, Krishna Kumar, Michael Leong, Liong Liem, Gladstone McDowell, Sunil J Panchal, Richard Rauck, Michael Saulino, Peter Staats, Michael Stanton-Hicks, Lisa Stearns, B Todd Sitzman, Mark Wallace, K Dean Willis, William Witt, Tony Yaksh, and Nagy Mekhail.
• Center for Pain Relief, Charleston, WV 25301, USA. doctdeer@aol.com
• Neuromodulation. 2012 Sep 1;15(5):420-35; discussion 435.

IntroductionTrialing for intrathecal pump placement is an essential part of the decision-making process in placing a permanent device. In both the United States and the international community, the proper method for trialing is ill defined.MethodsThe Polyanalgesic Consensus Conference (PACC) is a group of well-published experienced practitioners who meet to update the state of care for intrathecal therapies on the basis of current knowledge in the literature and clinical experience. Anexhaustive search is performed to create a base of information that the panel considers when making recommendations for best clinical practices. This literature, coupled with clinical experience, is the basis for recommendations and for identification of gaps in the base of knowledge regarding trialing for intrathecal pump placement.ResultsThe panel has made recommendations for the proper methods of trialing for long-term intrathecal drug delivery.ConclusionThe use of intrathecal drug delivery is an important part of the treatment algorithm for moderate to severe chronic pain. It has become common practice to perform a temporary neuroaxial infusion before permanent device implantation. On the basis of current knowledge, the PACC has developed recommendations to improve care. The need to update these recommendations will be very important as new literature is published.© 2012 International Neuromodulation Society.

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