RT Book, Section
A1 Li, Sean
A1 Staats, Peter S.
A2 Diwan, Sudhir
A2 Staats, Peter S.
SR Print(0)
ID 1107200084
T1 Permanent Implant
T2 Atlas of Pain Medicine Procedures
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071738767
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107200084
RD 2024/04/20
AB The  use  of  intrathecal  opioids  dates  back  to  August  16,  1898,  when  August  Bier  and  his  assistant  Hildebrandt  performed  “cocainization  of  the  spinal  cord”  on  each  other.  Unfortunately,  Bier  was  also  the  first  to  describe  the  complication  of  postdural  puncture  headache  from  his  personal  experience.  The  mechanism  of  opioids  on  the  spinal  cord  was  later  confirmed  in  a  rat  model.1  Subsequently,  intrathecal  medication  has  been  widely  utilized  for  both  anesthesia  and  analgesia.  The  use  of  implantable  intrathecal  drug  delivery  systems  began  in  the  early  1980s  and  is  now  indicated  for  use  in  patients  with  persistent  chronic  pain  of  malignant  and  nonmalignant  origin  that  are  either  refractory  to  maximal  medical  therapy  or  dose  limited  due  to  significant  side  effects,  and  has  been  demonstrated  to  have  a  better  side  effect  profile  than  systemic  opiates  alone.2  In  addition,  non-narcotic  medications  that  can  have  minimal  analgesia  when  administered  systemically  can  be  very  effective  when  administered  intrathecally.3