Intraspinal techniques for @entity158 management in @entity5 XXXX : a systematic review.

@entity5 @entity23 @entity1 @entity158
PURPOSE: This systematic review outlines current evidence regarding the effectiveness of intraspinal techniques for @entity5 and addresses practical implementation issues. METHODS: A search of electronic databases identified systematic reviews and @entity23 ( @entity23 ) evaluating the effectiveness of intraspinal techniques in the setting of @entity5 . An environmental scan was completed via the internet to identify practice guidelines and resource documents addressing organizational and implementation issues in the delivery of intraspinal analgesia. Elements reviewed included @entity1 selection, contraindications, monitoring, aftercare, follow-up, hospital discharge equipment, health personnel, @entity1 education, and safety. MAIN RESULTS: Three systematic reviews, three consensus conferences, and 12 @entity23 met the inclusion criteria for evidence of effectiveness. No single systematic review or consensus conference included all relevant @entity23 or specifically addressed the use of intraspinal techniques for @entity5 . Six @entity23 compared intraspinal techniques alone or combined with other interventions alone or in combination, four compared different intraspinal medications, and two compared different intraspinal techniques. In general, the evidence supported the use of intraspinal techniques for @entity5 management. The two main indications consistently identified were intractable @entity158 not controlled by other conventional medical routes and/or side effects from conventional @entity158 management strategies preventing dose escalation. Reports indicate intraspinal analgesia is equally or more effective than conventional medical management and often associated with fewer side effects. Thirteen resource documents addressed issues surrounding the delivery of intraspinal analgesia and program implementation. CONCLUSIONS: Intraspinal techniques monitored by an interprofessional health care team should be included as part of a comprehensive @entity5 management program.
