Evidence map›Paper›PMID 26501979›Full record

ReviewDrugs2015

Intrathecal Analgesia for Chronic Refractory Pain: Current and Future Prospects.

Catherine Smyth, Nadera Ahmadzai, Jason Wentzell, Ashley Pardoe, Andrew Tse, Tiffany Nguyen, Yvette Goddard, Shona Nair, Patricia A Poulin, Becky Skidmore and 1 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Drugs, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Development of a self-management manual for patients with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system: a Delphi study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Effects of NOP-Related Ligands in Nonhuman Primates.Handbook of experimental pharmacology · 2019
    Article
  9. Review
  10. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Catherine SmythDepartment of Anesthesiology, University of Ottawa and Ottawa Hospital Research Institute, The Ottawa Hospital-General Campus, 501 Smyth Rd., CCW 1551, Ottawa, ON, K1H 8L6, Canada. csmyth@toh.on.ca.
Nadera AhmadzaiKnowledge Synthesis Group, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Jason WentzellDepartment of Pharmacy, The Ottawa Hospital, Ottawa, ON, Canada.
Ashley PardoeDepartment of Anesthesiology, University of Ottawa, The Ottawa Hospital-General Campus, 501 Smyth Rd., CCW 1551, Ottawa, ON, K1H 8L6, Canada.
Andrew TseDepartment of Anesthesiology, University of Ottawa, The Ottawa Hospital-General Campus, 501 Smyth Rd., CCW 1551, Ottawa, ON, K1H 8L6, Canada.
Tiffany NguyenDepartment of Pharmacy, The Ottawa Hospital, Ottawa, ON, Canada.
Yvette GoddardDepartment of Anesthesiology, University of Ottawa, The Ottawa Hospital-General Campus, 501 Smyth Rd., CCW 1551, Ottawa, ON, K1H 8L6, Canada.
Shona NairDepartment of Anesthesiology, University of Ottawa, The Ottawa Hospital-General Campus, 501 Smyth Rd., CCW 1551, Ottawa, ON, K1H 8L6, Canada.
Patricia A PoulinDepartments of Anesthesiology and Psychology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Becky Skidmore, Ottawa, Canada.
Mohammed T AnsariFaculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
University of Ottawa · CAOttawa Hospital · CAOttawa Hospital Research Institute

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The intrathecal drug-delivery system (IDDS) is one mode of infusing analgesic medications directly into the cerebrospinal fluid in close proximity to their site of action. This modality has been employed in patients with refractory pain either due to malignant or non-malignant causes for over 30 years. Unfortunately, and despite the number of years it has been in use, there is still a scarcity of rigorous evidence to guide its integration into clinical practice. Current best evidence is inconclusive as to the comparative effectiveness and harms of the IDDS relative to routine medical care of patients. There are far more systematic reviews than high-quality primary comparative studies of the IDDS vs. conventional pain treatment. Existing clinical practice recommendations are best viewed as expert opinion with competing interests. This article will review the existing literature for indications, contraindications, consensus statements, different technologies, and complications of the IDDS. Although approved analgesics for IDDS delivery are limited to morphine and ziconotide, many other analgesics, alone or in combination, are routinely used in this setting. This review will also focus on the pharmacology, clinical efficacy, and safety of intrathecal medications extensively used in clinical practice; including agents approved, unapproved, and under development.

Indexed as

Injections, SpinalAnalgesicsContraindicationsEquipment and SuppliesHumansIntractable PainModels, NeurologicalPain ManagementAnalgesics

Identifiers

PMID26501979
OpenAlexW2288852178

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.