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| | Intrathecal Drug Delivery with the SynchroMed® System
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Building on the success of SynchroMed EL, which
was introduced in the 1980's and has been implanted in more than 50,000
patients worldwide, SynchroMed II is an advanced, fully implantable, programmable,
long-term intrathecal drug delivery system for the treatment of pain,
spasticity and cancer. Its many new features enhance patient quality of
life and streamline the process of patient management.
SynchroMed is ideal for patients whose pain state
and analgesic requirements are expected to fluctuate within a day and
vary over time. In contrast to fixed rate pumps which are typically used
for predictable stable pain profiles, SynchroMed allows pain-relieving
drugs, such as morphine, to be delivered at a variety of flow rates to
optimise therapy.
As SynchroMed is a totally implantable system,
it reduces the risk of infection compared to the long-term use of external
systems and does not restrict daily activities. The programmable pump
allows clinicians to adjust doses non-invasively, minimising patient discomfort.
Furthermore, the pump can be programmed to deliver different doses at
various times of the day, thereby meeting each patients' specific needs.
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Clinical
advantages of Intrathecal drug delivery with the SynchroMed infusion
system
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- Good to excellent pain relief in 65-95%
of patients [2,5,6]
- Reduces the need for additional pain medications
[2,5]
- Reduces side-effects in comparison to
oral/parenteral narcotics eg addiction
and tolerance [7-9]
- Site-specific delivery means lower opioid
doses e.g. the equivalent of 1/300th
of an oral dosage of morphine can often provide effective pain
relief [1,2,3]
- Less sedation and constipation than systemic
drugs [2]
- Improves activities of daily living [2,4,5]
- Enhances overall mood [2,5,6]
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| References |
1. Paice J,
Penn R, Schott S. Intraspinal morphine for chronic pain: a retrospective
multicenter study.
J Pain Symptom Manage 1996;11:71-80
2. Winkelmuller M, Winkelmuller W. Long-term effects of continuous intrathecal
opioid treatment in chronic
pain of nonmalignant etiology. J Neurosurg 1996;85:458-467
3. Krames ES. Intraspinal opioid therapy for chronic nonmalignant pain:
current practice and clinical guidelines.
J Pain Symptom Manage 1996;11:333-352
4. Kanoff R. Intraspinal deliver of opiates by an implantable, programmable
pump in patients with chronic
intractable pain of nonmalignant origin. Journal of
the American Osteopathic Society 1994;6:487-493
5. Penn R, Paice J. Chronic intrathecal morphine for intractable pain. J
Neurosurg 1987;67:182-186
6. Auld A, Maki-Jokela A, Murdoch D. Intraspinal narcotic analgesia in the
treatment of chronic pain.
Spine 1985;10:777-781
7. Plummer J, Cherry D, Cousins M et al. Long-term spinal administration
of morphine in cancer
and non-cancer pain: a retrospective study. Pain 1999;44:215-220
8. Follet K, Hitchen P, Piper J. Response of intractable pain to continuous
intrathecal morphine:
a retrospective study. Pain 1992;49:21-25
9. Gilmer-Hill, Biggan J, Smith K et al. Intrathecal morphine delivered
via subcutaneous pump for intractable
pain in pancreatic cancer. Surg Neurol 1999;51:6-11 |
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