Pain management, including intrathecal pumps.

摘要: Even when managed according to guidelines, approximately 14% of cancer patients have unrelieved pain or unacceptable side effects, and there is good evidence that still are not receiving optimal therapy. Implantable drug delivery systems (IDDS) administer small amounts drugs directly the spinal cord reduce systemic narcotic exposure by a factor 300 one. In large randomized trial 202 with scores 7.5 higher, despite 200 mg more morphine equivalent narcotics, IDDS gave better clinical success than comprehensive medical management (84.5% vs 70.8%, P=0.05). Pain were reduced 52% versus 39%, toxicity 50% 17%, lived longer. most refractory patients--those failed month experts--when subsequently provided IDDS, had 27% reduction in effects. Given multiple positive cohort studies high-power trial, should be considered as best treatment for this population.