Publications by authors named "Marilyn S Jacobs"
Introduction: Intrathecal (IT) drug infusion is an appropriate and necessary tool in the algorithm to treat refractory cancer and noncancer pain. The decision-making steps/methodology for selecting appropriate patients for implanted targeted drug delivery systems is controversial and complicated. Therefore, a consensus on best practices for determining appropriate use of IT drug infusion may involve testing/trialing this therapy before implantation.
View Article and Find Full Text PDFIntroduction: Pain treatment is best performed when a patient-centric, safety-based philosophy is used to determine an algorithmic process to guide care. Since 2007, the International Neuromodulation Society has organized a group of experts to evaluate evidence and create a Polyanalgesic Consensus Conference (PACC) to guide practice.
Methods: The current PACC update was designed to address the deficiencies and innovations emerging since the previous PACC publication of 2012.
Introduction: Targeted intrathecal drug infusion to treat moderate to severe chronic pain has become a standard part of treatment algorithms when more conservative options fail. This therapy is well established in the literature, has shown efficacy, and is an important tool for the treatment of both cancer and noncancer pain; however, it has become clear in recent years that intrathecal drug delivery is associated with risks for serious morbidity and mortality.
Methods: The Polyanalgesic Consensus Conference is a meeting of experienced implanting physicians who strive to improve care in those receiving implantable devices.
Article Synopsis
- The use of intrathecal (IT) infusion for chronic refractory pain has grown since the 1980s, prompting ongoing clinical research and expert recommendations from the Polyanalgesic Consensus Conference (PACC) in the years 2000, 2003, and 2007.
- In 2011, the PACC panel updated IT therapy standards based on new literature and clinical experiences since their last meeting, which involved a comprehensive literature review and discussions among panel members.
- The panel's updated algorithms for managing neuropathic and nociceptive pain represent a significant advancement in patient care, highlighting the need for continued research, new drug development, and enhanced safety measures for chronic pain treatment.
Introduction: Continuous intrathecal infusion of drugs to treat chronic pain and spasticity has become a standard part of the algorithm of care. The use of opioids has been associated with noninfectious inflammatory masses at the tip of the intrathecal catheter, which can result in neurologic complications.
Methods: The Polyanalgesic Consensus Conference is a meeting of a group of well-published and experienced practitioners; the purpose of the meeting is to update the standard of care for intrathecal therapies to reflect current knowledge gleaned from literature and clinical experience.