Yoshida G M, Nelson R W, Capen D A, Nagelberg S, Thomas J C, Rimoldi R L, Haye W
Complex Spine Clinic, Rancho Los Amigos Medical Center, Downey, California, USA.
Am J Orthop (Belle Mead NJ). 1996 Oct;25(10):693-4.
Intraspinal narcotic analgesia (INA) has been used for chronic pain from nonmalignant causes with moderate success. To ascertain the efficacy of the morphine pump, we reviewed the 2-year results of continuous INA in 18 patients with failed back syndrome or arachnoiditis and intractable, debilitating pain that was unrelieved by conventional means. All patients underwent a trial screening of single-dose intrathecal narcotics with good pain relief. After 2 years, 8 pumps were still functioning, 8 patients had the pump removed or turned off, and 2 patients were lost to follow-up. Our patients averaged 1.4 additional procedures or hospitalizations after initial pump insertion. Overall, only 4 patients had objective evidence of benefit from INA, for a success rate of 25%. Results of this review suggest INA should not be used for the long-term management of chronic pain from nonmalignant causes.
椎管内麻醉镇痛（INA）已用于治疗非恶性原因引起的慢性疼痛，取得了一定的成功。为了确定吗啡泵的疗效，我们回顾了18例腰椎术后失败综合征或蛛网膜炎患者连续进行INA治疗2年的结果，这些患者患有顽固性、使人衰弱的疼痛，常规方法无法缓解。所有患者均接受了单剂量鞘内注射麻醉剂的试验性筛查，疼痛得到了良好缓解。2年后，8个泵仍在正常工作，8例患者移除或关闭了泵，2例患者失访。我们的患者在最初植入泵后平均又接受了1.4次手术或住院治疗。总体而言，只有4例患者有客观证据表明从INA中获益，成功率为25%。该综述结果表明，INA不应长期用于治疗非恶性原因引起的慢性疼痛。
