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Updated: May 25, 2026
02:26
Intracranial Pharmacotherapy and Pain Assays in Rodents
Published on: April 9, 2019
Intracerebroventricular opioids for intractable pain
Robert B Raffa1, Joseph V Pergolizzi
1Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA 19140, USA. robert.raffa@temple.edu
British Journal of Clinical Pharmacology
|February 3, 2012
Summary
Intracerebroventricular (ICV) morphine infusion offers a safe and effective option for refractory pain in terminally ill patients at home. This palliative care method demonstrates good efficacy with minimal adverse effects, preserving patient alertness.
Area of Science:
- Palliative Care
- Pain Management
- Neurosurgery
Background:
- Refractory pain limits palliative care options, especially for home-based end-of-life care.
- Systemic analgesics and standard palliative procedures may be insufficient for severe pain.
- Intracerebroventricular (ICV) opioid infusion presents a potential alternative for intractable pain management.
Purpose of the Study:
- To review the efficacy and safety of ICV opioid administration.
- To assess the evidence for ICV morphine in home-based palliative care.
- To evaluate ICV opioids as a treatment for refractory pain.
Main Methods:
- Comprehensive literature search of bibliographic sources, including PubMed.
- Summarization and evaluation of existing basic and clinical evidence.
- Assessment of reported outcomes for ICV opioid therapy in refractory pain patients.
Main Results:
- ICV morphine infusion has shown good efficacy in the majority of terminally ill patients with refractory pain since the 1980s.
- Analgesic tolerance was not a significant issue with ICV morphine.
- Adverse effects like constipation and respiratory depression were infrequent, with preserved alertness.
Conclusions:
- Intracerebroventricular infusion of opioid analgesics is a safe and effective palliative therapy.
- ICV opioids provide a viable option for refractory pain management in home settings.
- This route offers significant benefits for patients seeking end-of-life care at home.
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