RT Book, Section
A1 Pope, Jason E.
A1 Deer, Timothy R.
A2 Bajwa, Zahid H.
A2 Wootton, R. Joshua
A2 Warfield, Carol A.
SR Print(0)
ID 1131938590
T1 Intrathecal Drug Delivery: An Overview of Modern Concepts in Advanced Pain Care
T2 Principles and Practice of Pain Medicine, 3e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071766838
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1131938590
RD 2024/04/20
AB The  concept  of  placement  of  drugs  into  the  cerebral  spinal  fluid  (CSF)  to  impact  a  patient's  perception  or  sensation  is  not  a  novel  concept.  In  the  early  19th  century  scientists  and  physicians  sought  this  route  to  impact  health  care.  Early  pioneers  of  this  therapy  can  be  traced  back  to  the  origins  of  spinal  anesthesia,  and  many  people  are  responsible  for  the  current  state  of  the  art.1  In  1885,  Corning  performed  the  first  “spinal  block.”  This  was  followed  by  August  Bier  in  Germany,  who  was  a  self-volunteer  for  a  spinal  injection.  In  1898,  the  first  spinal  anesthetic  was  documented  using  cocaine  as  the  drug,  followed  in  1901  with  the  first  epidural  used  for  pain  treatment.  The  use  of  corticosteroids  for  treatment  of  pain  occurred  in  1952.  Development  of  newer  agents  slowed  at  this  point,  with  no  major  advances  until  the  1980s  when  intrathecal  morphine  and  intrathecal  baclofen  were  approved  for  the  treatment  of  chronic  pain  and  spasticity,  respectively.2  Ziconotide  received  US  Food  and  Drug  Administration  (FDA)  approval  in  2004  as  a  non-opioid  intrathecal  alternative  for  treatment  of  pain.  Current  studies  have  been  conducted  on  hydromorphone,  gabapentin,  octreotide,  and  new  calcium  channel  blocking  drugs,  but  no  new  positive  reports  have  been  noted.  The  history  of  intrathecal  therapy  has  been  shaped  by  a  series  of  consensus  conferences  that  have  given  guidance  based  on  information  provided  by  experts  in  the  field.  The  history  to  be  written  in  the  next  decade  will  most  likely  focus  on  new  drugs  and  improved  safety.