Drug Selection for Intrathecal Drug Delivery

  • Timothy R. Deer


The use of intrathecal agents to treat pain and other diseases such as spasticity is based on the principle that delivering drugs directly to the cerebral spinal fluid (CSF) bypasses the first-pass effect and results in a higher degree of effectiveness when compared with other routes of delivery such as the oral or transdermal approach. The result of this improvement in delivery is a favorable equipotent dosing comparison. It also results in less impact on the end organs and overall reduced systemic drug exposure.


Cerebral Spinal Fluid Opioid Therapy Inflammatory Mass Intrathecal Therapy Risk Avoidance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. 1.
    Deer T, Krames E, Hassenbusch S, et al. Polyanalgesic consensus conference 2007: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel. Neuromodulation. 2007;10(4):300–328.Google Scholar
  2. 2.
    Hassenbusch S, Portenoy R, Cousins M, et al. Polyanalgesic consensus conference 2003: an update on the management of pain by intraspinal drug delivery – report of an expert panel. J Pain Symptom Manage. 2004;27(6):540–563.PubMedCrossRefGoogle Scholar
  3. 3.
    Bennett G, Burchiel K, Classen A, et al. Clinical guidelines for intraspinal infusion: report of an expert panel. Polyanalgesic Consensus Conference 2000. J Pain Symptom Manage. 2000;20(2):S37–S43.PubMedCrossRefGoogle Scholar
  4. 4.
    Deer T, Caraway D, Kim C. Clinical experience with intrathecal bupivacaine in combination with opioid for the treatment of chronic pain related to failed back surgery syndrome and metastatic cancer pain of the spine. Spine J. 2002;2(4):274–278.PubMedCrossRefGoogle Scholar
  5. 5.
    Deer T, Krames E, Hassenbusch S, et al. Future directions for intrathecal pain management: a review and update from the interdisciplinary polyanalgesic consensus conference 2007. Neuromodulation. 2008;2(11):92–97.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Center for Pain ReliefCharlestonUSA

Personalised recommendations