Intracerebroventricular Opioid Infusion Feasible at Home

Effective for treatment of refractory pain in terminal patients; low incidence of adverse events

THURSDAY, Feb. 9 (HealthDay News) -- Intracerebroventricular (ICV) infusion of opioids is safe and effective for the treatment of nonresponsive pain in terminally-ill patients in home settings, according to a review published online Feb. 1 in the British Journal of Clinical Pharmacology.

Robert B. Raffa, Ph.D., of the Temple University School of Pharmacy, and Joseph V. Pergolizzi Jr., M.D., of the Temple University School of Medicine -- both in Philadelphia, conducted a systematic literature review to evaluate the efficacy and safety of ICV opioids for pain relief in terminally-ill patients unresponsive to other pain treatments.

The researchers found that such treatment has been reported since the early 1980s. For the vast majority of patients, good efficacy was achieved, without serious development of analgesic tolerance. The incidence of adverse events, such as constipation and respiratory depression, was low. This route of administration was associated with a significant retention of alertness.

"The administration of ICV opioid for palliative care in the home setting is associated with opportunities and challenges. The objective benefits of ICV administration of opioid pain relievers appear to include good efficacy, relative ease of insertion and infusion, modest dose escalation, and relatively low incidence of and severity of opioid side effects, particularly constipation and mental clouding," the authors write.

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