Patient selection for the treatment of chronic intractable pain requires a closer examination of criteria. In most cases, a psychological evaluation is indicated to examine factors such as patient expectations, psychosomatic components of the pain, and secondary gain motivation.
Selection guidelines for patients with chronic intractable pain include:
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. See SynchroMed product labeling for more information.
Prager, J., et al. (2014), Best Practices for Intrathecal Drug Delivery for Pain. Neuromodulation: Technology at the Neural Interface, 17: 354–372. doi:10.1111/ner.12146.