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Implantable devices for pain control: spinal cord stimulation and intrathecal therapies
Untreated chronic pain is costly to society and to the individual suffering from it. The treatment of chronic pain, a multidimensional disease, should rely on the expertise of varying health care providers and should focus not only on the neurobiological mechanisms of the process but also on the psy...
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| Published in: | Best practice & research. Clinical anaesthesiology 2002-12, Vol.16 (4), p.619-649 |
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| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c255t-4688eaeaf4ab07293bc4ea309d3f0218a01ccd3b131ea6f8563ababecae9683a3 |
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| cites | cdi_FETCH-LOGICAL-c255t-4688eaeaf4ab07293bc4ea309d3f0218a01ccd3b131ea6f8563ababecae9683a3 |
| container_end_page | 649 |
| container_issue | 4 |
| container_start_page | 619 |
| container_title | Best practice & research. Clinical anaesthesiology |
| container_volume | 16 |
| creator | Krames, Elliot |
| description | Untreated chronic pain is costly to society and to the individual suffering from it. The treatment of chronic pain, a multidimensional disease, should rely on the expertise of varying health care providers and should focus not only on the neurobiological mechanisms of the process but also on the psychosocial aspects of the disease. Implantable devices are costly and invasive, and such efficacious therapies should be used only when more conservative and less costly therapies have failed to provide relief of pain and suffering. Spinal cord stimulation provides neuromodulation of neuropathic, but not nociceptive, pain signals and when used for appropriate indications in the right individuals provides approximately 60–80% long-term pain relief in 60–80% of patients trialled for efficacy. Intrathecal therapies with opioids such as morphine, fentanyl, sufentanil or meperidine – or non-opioids such as clonidine or bupivacaine – provide analgesia in patients with nociceptive or neuropathic pain syndromes. Baclofen, intrathecally, provides profound relief of muscle spasticity due to multiple sclerosis, spinal cord injuries, brain injuries or cerebral palsy. |
| doi_str_mv | 10.1053/bean.2002.0263 |
| format | article |
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The treatment of chronic pain, a multidimensional disease, should rely on the expertise of varying health care providers and should focus not only on the neurobiological mechanisms of the process but also on the psychosocial aspects of the disease. Implantable devices are costly and invasive, and such efficacious therapies should be used only when more conservative and less costly therapies have failed to provide relief of pain and suffering. Spinal cord stimulation provides neuromodulation of neuropathic, but not nociceptive, pain signals and when used for appropriate indications in the right individuals provides approximately 60–80% long-term pain relief in 60–80% of patients trialled for efficacy. Intrathecal therapies with opioids such as morphine, fentanyl, sufentanil or meperidine – or non-opioids such as clonidine or bupivacaine – provide analgesia in patients with nociceptive or neuropathic pain syndromes. 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Clinical anaesthesiology</title><addtitle>Best Pract Res Clin Anaesthesiol</addtitle><description>Untreated chronic pain is costly to society and to the individual suffering from it. The treatment of chronic pain, a multidimensional disease, should rely on the expertise of varying health care providers and should focus not only on the neurobiological mechanisms of the process but also on the psychosocial aspects of the disease. Implantable devices are costly and invasive, and such efficacious therapies should be used only when more conservative and less costly therapies have failed to provide relief of pain and suffering. Spinal cord stimulation provides neuromodulation of neuropathic, but not nociceptive, pain signals and when used for appropriate indications in the right individuals provides approximately 60–80% long-term pain relief in 60–80% of patients trialled for efficacy. Intrathecal therapies with opioids such as morphine, fentanyl, sufentanil or meperidine – or non-opioids such as clonidine or bupivacaine – provide analgesia in patients with nociceptive or neuropathic pain syndromes. Baclofen, intrathecally, provides profound relief of muscle spasticity due to multiple sclerosis, spinal cord injuries, brain injuries or cerebral palsy.</description><subject>Adrenergic alpha-Agonists - administration & dosage</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Calcium Channel Blockers - administration & dosage</subject><subject>Chronic Disease</subject><subject>Drug Combinations</subject><subject>Electric Stimulation Therapy - instrumentation</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Electrodes, Implanted</subject><subject>Humans</subject><subject>implantable devices</subject><subject>Infusion Pumps, Implantable</subject><subject>Injections, Spinal</subject><subject>intrathecal therapies</subject><subject>Narcotics - administration & dosage</subject><subject>Pain, Intractable - physiopathology</subject><subject>Pain, Intractable - therapy</subject><subject>Spinal Cord - physiopathology</subject><subject>Spinal Cord - surgery</subject><subject>spinal cord stimulation</subject><issn>1521-6896</issn><issn>1532-169X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><recordid>eNp1kMtLAzEQh4MotlavHmVP3rbm0d1mvYn4KBS8KHoLk2QWI_syyRb8783SgidPMxm-_Ib5CLlkdMloIW40QrfklPIl5aU4InNWCJ6zsvo4nnrO8lJW5YychfBFKWVrWZ2SGeMFS_NiTt437dBAF0E3mFncOYMhq3ufDeC6zPRd9H1zm4XBddCkt7dZiK4dG4iu7zLobOYSA_ETTQJS8TA4DOfkpIYm4MWhLsjb48Pr_XO-fXna3N9tc8OLIuarUkoEhHoFmq55JbRZIQhaWVFTziRQZowVmgmGUNayKAVo0GkXVqUUIBbkep87-P57xBBV64LBJt2E_RjUmktaMckTuNyDxvcheKzV4F0L_kcxqiaValKpJpVqUpk-XB2SR92i_cMP7hIg9wCm-3YOvQrGYWfQOo8mKtu7_7J_AY_shLk</recordid><startdate>200212</startdate><enddate>200212</enddate><creator>Krames, Elliot</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200212</creationdate><title>Implantable devices for pain control: spinal cord stimulation and intrathecal therapies</title><author>Krames, Elliot</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c255t-4688eaeaf4ab07293bc4ea309d3f0218a01ccd3b131ea6f8563ababecae9683a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adrenergic alpha-Agonists - administration & dosage</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Calcium Channel Blockers - administration & dosage</topic><topic>Chronic Disease</topic><topic>Drug Combinations</topic><topic>Electric Stimulation Therapy - instrumentation</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Electrodes, Implanted</topic><topic>Humans</topic><topic>implantable devices</topic><topic>Infusion Pumps, Implantable</topic><topic>Injections, Spinal</topic><topic>intrathecal therapies</topic><topic>Narcotics - administration & dosage</topic><topic>Pain, Intractable - physiopathology</topic><topic>Pain, Intractable - therapy</topic><topic>Spinal Cord - physiopathology</topic><topic>Spinal Cord - surgery</topic><topic>spinal cord stimulation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krames, Elliot</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Best practice & research. Clinical anaesthesiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krames, Elliot</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implantable devices for pain control: spinal cord stimulation and intrathecal therapies</atitle><jtitle>Best practice & research. Clinical anaesthesiology</jtitle><addtitle>Best Pract Res Clin Anaesthesiol</addtitle><date>2002-12</date><risdate>2002</risdate><volume>16</volume><issue>4</issue><spage>619</spage><epage>649</epage><pages>619-649</pages><issn>1521-6896</issn><eissn>1532-169X</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><notes>ObjectType-Review-1</notes><abstract>Untreated chronic pain is costly to society and to the individual suffering from it. The treatment of chronic pain, a multidimensional disease, should rely on the expertise of varying health care providers and should focus not only on the neurobiological mechanisms of the process but also on the psychosocial aspects of the disease. Implantable devices are costly and invasive, and such efficacious therapies should be used only when more conservative and less costly therapies have failed to provide relief of pain and suffering. Spinal cord stimulation provides neuromodulation of neuropathic, but not nociceptive, pain signals and when used for appropriate indications in the right individuals provides approximately 60–80% long-term pain relief in 60–80% of patients trialled for efficacy. Intrathecal therapies with opioids such as morphine, fentanyl, sufentanil or meperidine – or non-opioids such as clonidine or bupivacaine – provide analgesia in patients with nociceptive or neuropathic pain syndromes. Baclofen, intrathecally, provides profound relief of muscle spasticity due to multiple sclerosis, spinal cord injuries, brain injuries or cerebral palsy.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>12516895</pmid><doi>10.1053/bean.2002.0263</doi><tpages>31</tpages></addata></record> |
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| identifier | ISSN: 1521-6896 |
| ispartof | Best practice & research. Clinical anaesthesiology, 2002-12, Vol.16 (4), p.619-649 |
| issn | 1521-6896 1532-169X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72809182 |
| source | ScienceDirect Freedom Collection |
| subjects | Adrenergic alpha-Agonists - administration & dosage Analgesics, Opioid - administration & dosage Anesthetics, Local - administration & dosage Calcium Channel Blockers - administration & dosage Chronic Disease Drug Combinations Electric Stimulation Therapy - instrumentation Electric Stimulation Therapy - methods Electrodes, Implanted Humans implantable devices Infusion Pumps, Implantable Injections, Spinal intrathecal therapies Narcotics - administration & dosage Pain, Intractable - physiopathology Pain, Intractable - therapy Spinal Cord - physiopathology Spinal Cord - surgery spinal cord stimulation |
| title | Implantable devices for pain control: spinal cord stimulation and intrathecal therapies |
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