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Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2010

01-02-2010 | Review Article

Intraspinal techniques for pain management in cancer patients: a systematic review

Authors: Jeff Myers, Vincent Chan, Virginia Jarvis, Cindy Walker-Dilks

Published in: Supportive Care in Cancer | Issue 2/2010

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Abstract

Purpose

This systematic review outlines current evidence regarding the effectiveness of intraspinal techniques for cancer pain and addresses practical implementation issues.

Methods

A search of electronic databases identified systematic reviews and randomized controlled trials (RCTs) evaluating the effectiveness of intraspinal techniques in the setting of cancer pain. 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 patient selection, contraindications, monitoring, aftercare, follow-up, hospital discharge equipment, health personnel, patient education, and safety.

Main results

Three systematic reviews, three consensus conferences, and 12 RCTs met the inclusion criteria for evidence of effectiveness. No single systematic review or consensus conference included all relevant RCTs or specifically addressed the use of intraspinal techniques for cancer pain. Six RCTs 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 cancer pain management. The two main indications consistently identified were intractable pain not controlled by other conventional medical routes and/or side effects from conventional pain 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 cancer pain management program.
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Metadata
Title
Intraspinal techniques for pain management in cancer patients: a systematic review
Authors
Jeff Myers
Vincent Chan
Virginia Jarvis
Cindy Walker-Dilks
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 2/2010
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0784-2

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