Intrathecal opioids: equally efficacious at any age.

Abstract

Intrathecal opioid pumps have been used in the management of severe chronic pain for more than 40years. Numerous studies have shown significant therapeutic effects alongside tolerable side effects. In the last decades, life expectancy has increased in many countries in the world. With an aging population, the question arises whether effects equal to those in younger patients can also be achieved in elderly patients. This study is an in-depth re-analysis of data published previously. 36 patients were analyzed. The sample included 18 elderly patients (> 65years) and 18 younger patients. No differences between the two samples were found with regard to pain intensity under intrathecal opioid therapy and prior to implantation of the opioid pump. Likewise, there were no differences in anxiety/depression scores and pain-related disability. Side effects were reported at similar rates by the elderly patients and by the younger patients. Elderly patients showed a tendency towards lower opioid doses and slower dose increases. Our data hint at a consistent efficacy of intrathecal opioid therapy in elderly patients even after long-term treatment. Side effects of the treatment are relatively frequent but mild and no side effects were particularly frequent in elderly people.