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Intrathecal Therapy: What Has Changed With the Introduction of Ziconotide
Pain Practice, 09/03/09

Kress HG et al. – Although morphine and ziconotide are the only intrathecal analgesics currently approved by regulatory authorities in the U.S. and Europe, a wide variety of opioid and non–opioid drugs are being used in this way. There is no official guidance concerning the selection of these drugs or their use in combinations and a paucity of efficacy and safety data from randomized controlled trials. The polyanalgesic initiative aims to summarize the current knowledge and to facilitate rational choices of intrathecal drug and drug combinations for the management of chronic pain. The most recent polyanalgesic consensus recommendations were published in 2007. In this review, the authors shall examine these recommendations, which are tailored toward those practicing intrathecal analgesia in the U.S., and discuss how they should be implemented in Europe, where the healthcare systems and regulations of the medical authorities are different.

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