Clinical Guidelines for Intraspinal Infusion: Report of an Expert Panel

• Published in: Journal of pain and symptom management Vol. 20; no. 2; pp. S37 - S43
• Main Authors: Bennett, Gary, Burchiel, Kim, Buchser, Eric, Classen, Ashley, Deer, Tim, Du Pen, Stuart, Ferrante, F.Michael, Hassenbusch, Samuel J, Lou, Leland, Maeyaert, Jan, Penn, Richard, Portenoy, Russell K, Rauck, Richard, Serafini, Mario, Willis, K.Dean, Yaksh, Tony
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2000; Elsevier Science
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; clinical practice; decision making; guidelines; Intraspinal therapy; intrathecal; Local anesthesia. Pain (treatment); Medical sciences; intrathecal; guidelines; clinical practice; Intraspinal therapy; decision making; Local anesthetic; Human; Analgesia; Chemotherapy; Chronic; Analgesic; Pain; Treatment; Narcotic analgesic; Long term; Intrathecal administration; Recommendation
• DOI: 10.1016/S0885-3924(00)00202-5
• ISSN: 0885-3924

Consensus guidelines developed by an expert panel are helpful to clinicians when there is variation in practice and lack of a firm evidence base for an intervention, such as intraspinal therapy for pain. An internet-based survey of practitioners revealed remarkable variation in practice patterns surrounding intraspinal therapy. This prompted an interdisciplinary panel with extensive clinical experience in intraspinal infusion therapy to evaluate the results of the survey, the systematic reviews of the literature pertaining to this approach, and their own clinical experience with long-term spinal infusions. The panel proposed a scheme for the selection of drugs and doses for intraspinal therapy, and suggested guidelines for administration that would increase the likelihood of a successful outcome. These expert panel guidelines were designed to provide an initial structure for clinical decision making that is based on the best available evidence and the perspectives of experienced clinicians.