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Intrathecal pain management: a team-based approach.

Jeremy A Adler1, Neona M Lotz2

  • 1Pacific Pain Medicine Consultants, Encinitas.

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Summary

Physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs) play key roles in managing chronic pain with intrathecal (IT) therapy. Their contributions include patient education, care, and treatment adjustments for optimal outcomes.

Keywords:
chronic painimplantable drug delivery systemmorphinepatient educationziconotide

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Area of Science:

  • Pain Management
  • Neuroscience
  • Pharmacology

Background:

  • Intrathecal (IT) therapy is a crucial modality for managing chronic pain.
  • Interprofessional collaboration is essential for effective pain management.
  • Physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs) are integral members of pain management teams.

Purpose of the Study:

  • To provide an overview of chronic pain management using IT therapy.
  • To highlight the specific contributions of PAs, NPs, and RNs in IT therapy.
  • To offer practical guidance for healthcare professionals administering IT therapy.

Main Methods:

  • A narrative review of literature from the Medline database.
  • Inclusion of relevant treatment guidelines for IT therapy.
  • Focus on the roles of PAs, NPs, and RNs in patient care.

Main Results:

  • PAs, NPs, and RNs are involved in patient selection, education, and ongoing care for IT therapy.
  • Key responsibilities include postimplant maintenance and supportive care.
  • Information on approved IT analgesics (morphine, ziconotide), dosing, titration, and adverse event management is provided.

Conclusions:

  • PAs, NPs, and RNs are valuable members of IT pain management teams.
  • Successful IT therapy requires continuous monitoring of efficacy and adverse effects.
  • Effective communication among healthcare professionals is vital for patient outcomes.