Chapter

Intrathecal drug delivery and neurolytic blocks

Karen H. Simpson and Iain Jones

in Neuropathic Pain

Second edition

Published on behalf of Oxford University Press

ISBN: 9780199563678
Published online May 2011 | e-ISBN: 9780199607426 | DOI: http://dx.doi.org/10.1093/med/9780199563678.003.0015

Series: Oxford Pain Management Library

Intrathecal drug delivery and neurolytic blocks

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• Intrathecal drug delivery (ITDD) allows drugs to be placed near to central receptors • Drug side-effects may be reduced as small doses are required compared to with systemic administration • External or internal ITDD systems are available • ITDD requires careful patient selection and preparation • Opioids, local anaesthetics, and clonidine are the most commonly used intrathecal drugs; ziconotide can be used as first line treatment • Neurolytic blocks are usually used for neuropathic pain arising from cancer or peripheral vascular disease • Coeliac plexus block for upper abdominal cancer pain or lumbar sympathectomy for ischaemic leg pain are very effective • Intracerebroventricular drug delivery is possible for head pain usually due to cancer; but it is rarely used.

Chapter.  3902 words.  Illustrated.

Subjects: Anaesthetics ; Pain Medicine

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