{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:18:24Z","timestamp":1787015904598,"version":"build-2736575974"},"reference-count":92,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,10,4]],"date-time":"2013-10-04T00:00:00Z","timestamp":1380844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic pain may recur after initial response to strong opioids in both patients with cancer and patients without cancer or therapy may be complicated by intolerable side effects. When minimally invasive interventional pain management techniques also fail to provide satisfactory pain relief, continuous intrathecal analgesic administration may be considered.<\/jats:p>\n                  <jats:p>\n                    Only 3 products have been officially approved for long\u2010term intrathecal administration: morphine, baclofen, and ziconotide. The efficacy of intrathecal ziconotide for the management of patients with severe chronic refractory noncancer pain was illustrated in 3 placebo\u2010controlled trials. A randomized study showed this treatment option to be effective over a short follow\u2010up period for patients with pain due to cancer or\n                    <jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>\n                    . The efficacy of intrathecal opioid administration for the management of chronic noncancer pain is mainly derived from prospective and retrospective noncontrolled trials. The effect of intrathecal morphine administration in patients with pain due to cancer was compared with oral or transdermal treatment in a randomized controlled trial, which found better pain control and fewer side effects with intrathecal opioids. Other evidence is derived from cohort studies. Side effects of chronic intrathecal therapy may either be technical (catheter or pump malfunction) or biological (infection). The most troublesome complication is, however, the possibility of granuloma formation at the catheter tip that may induce neurological damage. Given limited studies, the evidence for intrathecal drug administration in patients suffering from cancer\u2010related pain is more compelling than that of chronic noncancer pain.\n                  <\/jats:p>","DOI":"10.1111\/papr.12111","type":"journal-article","created":{"date-parts":[[2013,10,11]],"date-time":"2013-10-11T22:42:23Z","timestamp":1381531343000},"page":"461-476","source":"Crossref","is-referenced-by-count":45,"title":["Intrathecal Drug Administration in Chronic Pain Syndromes"],"prefix":"10.1111","volume":"14","author":[{"given":"Ann","family":"Ver Donck","sequence":"first","affiliation":[{"name":"Pain Center AZ Sint Jan Brugge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H.","family":"Vranken","sequence":"additional","affiliation":[{"name":"Pain Relief Unit Medical Center Alkmaar and Slotervaartziekenhuis Amsterdam The 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