Anesthesiology clinics
-
Since the first use of intrathecal (IT) drug infusion systems in the early 1980s, these delivery systems have undergone numerous revisions making them more tolerable, easier to program, and longer lasting. Concurrent with technological advances, the indications for IT pump placement have also been continuously evolving, to the point where the most common indication is now noncancer pain. This article provides an evidence-based review of the indications, efficacy, and complications of IT drug therapy for the most commonly administered spinal analgesics.
-
Anesthesiology clinics · Dec 2007
ReviewDocumentation and potential tools in long-term opioid therapy for pain.
The field of pain medicine is experiencing increased pressure from regulatory agencies and other sources regarding the continuation, or even initial use, of opioids in pain patients. Therefore, it is essential that pain clinicians provide rationale for engaging in this modality of treatment and provide ample documentation in this regard. Thus, assessment and documentation are cornerstones for both protecting your practice and obtaining optimal patient outcomes while on opioid therapy. Several potential tools and documentation strategies are discussed that will aid clinicians in providing evidence for the continuation of this type of treatment for their patients.
-
This article concentrates on recent evidence about opioid analgesics for persistent noncancer pain. Evidence confirms that opioids are drugs with a definite risk of adverse events. ⋯ Strong opioids should be reserved for patients who fail to respond to other lower-risk options and only after proper consideration is given to the long-term consequences of strong opioid use. Problems associated with opioids dictate that more efficacious and safer drugs need to be found.