Low-Dose Intrathecal Morphine Provides Consistent, Stable Analgesia for Chronic Nonmalignant Pain
PALM SPRINGS, CA — A 24-month follow-up of patients receiving low-dose intrathecal morphine via an implanted drug-delivery system found analgesia for chronic nonmalignant pain to be consistent and stable, Jay S. Grider, PhD, DO, of the University of Kentucky, Lexington, KY, reported during the 2012 American Academy of Pain Medicine Annual Meeting.
Recently, Dr. Grider and colleagues described a method of trialing candidates for intrathecal therapy using a low-dose opioid method.1 The current study reports results of an ongoing observational cohort of 21 consecutive patients ages 38–82 years who were “trialed, implanted, and maintained on a low-dose intrathecal morphine protocol provided by an implanted intrathecal drug-delivery system,” Dr. Grider noted.
At 24 months, patients were evaluated for ongoing analgesia and dose escalation. The average implant time was 23 months. Visual analog pain scores (VAS) and intrathecal opioid doses were evaluated as one group.
Compared with the initial 12 months, during which the average daily dose of intrathecal morphine was 335mcg/day, the dose was 348mcg/day at 24 months. VAS scores were 4.9 +/- SD 2.8 (range 0–10). Eighteen of the 21 patients rated ongoing analgesia as acceptable, consistent, and stable.
While there was a small increase in average VAS at 24 months compared with the first 12 months, most patients reported improved quality of life.
1. Grider JS, Harned ME, Etscheidt MA. Patient selection and outcomes using a low-dose intrathecal opioid trialing method for chronic nonmalignant pain. Pain Physician 2011;14:343-351.