Neuromodulation : journal of the International Neuromodulation Society
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The implantation of a drug (opioid) infusion system catheter at the level of the cisterna magna, connected to an implanted programmable pump (Synchromed pump, 8611-H, Medtronic, Minneapolis, MN) is the procedure we use most commonly for the treatment of craniofacial and upper cervical pain. Our implantation technique, which we consider simple and easy to perform, is discussed in this article. Our results have been extremely encouraging, without untoward effects occurring. Adverse effects are prevented by the close proximity of the catheter tip to the pain receptors.
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It was the purpose of this study to retrospectively test the safety and efficacy of the use of intraspinal analgesics in a diverse population of patients with chronic nonmalignant pain. This study was conducted in 39 patients, refractory to conventional therapies for intrathecal therapy. Twenty-two patients had neuropathic pain and 17 had nociceptive pain. ⋯ Other patient-reported side effects were not considered significant by the authors to be mentioned here. After more than 6 years of experience with spinal infusion of morphine, either alone or admixed with other spinal analgesics, in patients with pain of nonmalignant origin, we consider the technique to be helpful in selected patients not responding to oral treatment or when untoward side effects exist with oral treatment. The advantages, as regards to analgesic efficacy and quality of life, clearly outweigh the drawbacks of the long-term use of spinal morphine.