Abstract
This chapter describes the practical details of management of chronic intrathecal drug delivery. Intrathecal drug delivery for chronic pain and spasticity is a scientifically rational and evidence-based therapy. The primary objective of long-term intrathecal drug delivery of analgesics or antispasmodics is control of symptoms through maintenance of drug levels within an effective range. Totally implanted intrathecal drug delivery systems require a spinal catheter and a drug reservoir driven by an energy source. Intrathecal drug delivery is one of pain medicine’s more interventional methods. Intrathecal drug delivery should be undertaken in a multi professional context, with all team members having a role in selection, the delivery of ongoing care, and the management of complications. The intrathecal delivery of opioids can cause centrally mediated side effects such as respiratory depression, nausea and vomiting, constipation, urinary retention, pruritus, and sedation. Intrathecal local anesthetic delivery can cause cardiovascular instability, sensory deficits, urinary retention, and motor impairment.
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