[Analgesia with an implanted device for repetitive intrathecal injections of XXXX ].

@entity1 @entity5 @entity1337 @entity5827 @entity1286 @entity158 @entity1338
The use of intraspinal narcotics has been widely accepted as @entity158 relief treatment for intractable @entity5 . Intraspinal low doses of @entity1286 induce a potent selective long lasting @entity1337 . To avoid repetitive lumbar puncture, a drug delivery device was surgically implanted in 41 @entity1 . The surgical procedure is described. The mean amount of @entity1286 needed was 1.48 +/- 0.25 mg per day at time of surgery, rising to 6.86 +/- 1.47 mg per day after a mean survival time of 65 days. Tolerance became a major problem in 18 @entity1 , which nearly all were selected at a late disease stage and previously received narcotics for @entity158 relief. However, no clear-cut prognostic factor had a predictive value for the appearance of tolerance. In some cases, it could be successfully treated by intraspinal injection of local anaesthetics or @entity1338 . CSF leakage was noted in 11 @entity1 ; this was a challenge for us, as no other authors reported such a high rate for this complication. @entity5827 was noted three times. In all cases but one, the symptoms resolved with appropriate treatment.
