PATIENT SELECTION: CANCER PAIN Targeted Drug Delivery
For many cancer patients, oral analgesics may be adequate; however, those cancer patients with intractable pain who meet any of the criteria listed below may be appropriate for more advanced pain management techniques. Consider referring those patients to a pain management specialist for an evaluation, and to learn about options for chronic pain control using intrathecal opioids. Pending a successful intrathecal morphine trial, a permanent intrathecal catheter and Medtronic SynchroMed™ II programmable pump could be implanted for chronic pain control.
Note: It is important to consider increased assessment and referral vigilance for women,1,2,5,7 minorities,2,5-7 and the elderly,2,5,6 who have been shown to be at increased risk for inadequate analgesia.
Infection; implant depth greater than 2.5 cm below skin; insufficient body size; spinal anomalies; drugs with preservatives, drug contraindications, drug formulations with pH ≤3, use of catheter access port (CAP) kit for refills or of refill kit for catheter access, blood sampling through CAP in vascular applications, use of Personal Therapy Manager to administer opioid to opioid-naïve patients or to administer ziconotide. See SynchroMed product labeling for more information.
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