Programmable Intrathecal Opioid Delivery Systems for Chronic Nonmalignant Pain: A Systematic Review of Effectiveness and Complications

Investigators:   Jeanne Sears, Judy Turner, John Loeser

This report summarizes the methods and findings of a systematic review of the literature on the effectiveness of programmable intrathecal drug delivery systems (IDDS) in reducing pain and improving functioning of individuals with chronic nonmalignant pain, as well as the literature on complications associated with IDDS. Two drugs have been approved by the United States (U.S.) Food and Drug Administration (FDA) for use in IDDS to treat pain: morphine and ziconotide (approved for use with patients who have an IDDS and have failed to respond to morphine); however, opioids other than morphine and adjuvant medications also are used commonly with IDDS for pain. The review addressed two questions concerning intrathecal opioid and ziconotide delivery for the treatment of chronic nonmalignant pain via programmable IDDS:

  1. What are the effects on pain and functioning, and do they change over time?
  2. What are the types and rates of complications?