Intrathecal Hydromorphone for Intractable Nonmalignant Pain: A Retrospective Study

Background. Hydromorphone is often administered intrathecally for the treatment of cancer and nonmalignant chronic intractable pain. It is frequently utilized in combination with other analgesics in a multidrug intrathecal infusion; however, very little data are available documenting efficacy or safety of intrathecal hydromorphone as a solo analgesic. Objective. This study was conducted to examine pain and side effects in patients receiving intrathecal hydromorphone. Design. A retrospective review was conducted of all patients receiving intrathecal hydromorphone monotherapy in two large pain specialty practices in the Pacific Northwest. All data collected within 30 days of the patient's 3-month, 6-month, and 12-month anniversary of implant were analyzed. Patients. Twenty-four patients with noncancer-related chronic pain were included in the study. Thirteen patients had eligible pain data at 1 month, 10 patients had pain data at 3 months and seven patients had pain data available at 12 months after initiation of intrathecal hydromorphone. Results. Average pain scores decreased significantly ( P = 0.03). Side-effect and pain-interference scores remained essentially unchanged in this small sample of patients.