TY - CHAP M1 - Book, Section TI - Permanent Implant A1 - Li, Sean A1 - Staats, Peter S. A2 - Diwan, Sudhir A2 - Staats, Peter S. Y1 - 2015 N1 - T2 - Atlas of Pain Medicine Procedures 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 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/20 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1107200084 ER -