The study of long term intrathecal infusion opioids and/or baclofen in patients with chronic pain and/or severe spasticity via implanted delivery system constant flow: advantages of suggested drug combination doses and relevant techniques

In this thesis, we tried to study and determine the impact and long-term action methodologies intrathecal drug infusion using a special implanted pump in patients with symptoms of intense pain and severe spasticity. The study involved 80 patients, only patients in the Pain Management Unit of the General Hospital of Eleusis "Thria-sio", clinical or other departments of the same hospital or patients who have been re-ferred from other centers in the region that meet the selection criteria.The monitoring of the patients took place at predetermined time intervals (fol-low-up) (year "0" by recording the initial measurements at 15 days, 30 days and once monthly after the placement of the pump and for a period of 15 months) using the rel-evant scales (VAS, Ashworth and ACPA). In this study became statistical significant relationship between dose of morphine and the dose of baclofen on the quality of life (Ρ=0,028 and Ρ =0,014, respectively) on the 15th day of clinical monitoring.Our results show a long-lasting relief from chronic pain, as measured by the scale VAS, but an improvement of quality of life (fifteen months of the intervention), based on ACPA scale.However, the beneficial analgesic effect accompanied by a corresponding in-crease of the dose of all drugs administered. Specifically, all patients showed a reduc-tion in pain and spasticity, without any adverse pharmacological actions. The lack of adverse side effects attributable to the close monitoring of patients and gradual titra-tion to the needs and satisfaction with pain and spasticity.The results demonstrate the safety and effectiveness of intrathecal morphine, fen-tanyl, clonidine and/or baclofen for the treatment of refractory chronic persistent pain and severe spasticity