Hassenbusch S J
Department of Neurosurgery, M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
J Pain Symptom Manage. 1996 Jun;11(6):357-62. doi: 10.1016/0885-3924(96)00009-7.
As intraspinal opioid infusions are being offered to an increasing number of patients with chronic noncancer pain, technical considerations and complications have become important. For these technical considerations, there are points that are unclear and controversial and others that appear to be "minor" but, if missed, can lead to disastrous pump complications. Among the controversial areas are type of testing for a spinal infusion, method for needle placement in the spine, and type of pump. For the apparently minor considerations, important areas are attention to the method of puncture of the paraspinal fascia, anchoring of catheter, pump placement, and initial filling of the pump. As experience with these infusions is accumulated, and as the financial climate in medicine changes, the approaches to these techniques appear to be changing toward a general consensus. Recent scientific advances, both in newer analgesic substances and in innovative methods for intraspinal delivery of these substances, also are affecting these approaches.
随着越来越多的慢性非癌性疼痛患者接受脊髓内阿片类药物输注，技术考量和并发症已变得至关重要。对于这些技术考量，有些要点尚不清楚且存在争议，而其他一些要点看似“微不足道”，但如果被忽视，可能会导致灾难性的泵相关并发症。存在争议的领域包括脊髓输注的测试类型、脊柱穿刺针的放置方法以及泵的类型。对于那些看似微不足道的考量，重要的方面包括对椎旁筋膜穿刺方法的关注、导管的固定、泵的放置以及泵的初始填充。随着这些输注经验的积累，以及医学领域财务状况的变化，这些技术的应用方法似乎正朝着普遍共识发展。新型镇痛药物以及这些药物脊髓内给药创新方法方面的最新科学进展，也在影响着这些应用方法。
