Does intrathecal analgesic drug delivery place patients at higher risk of serious adverse events than other interventional pain procedures?
Recent observational studies suggest that patients who undergo permanent implantation of intrathecal drug delivery systems for the treatment of pain have a significantly higher risk of mortality than patients who receive other invasive interventions for their pain (e.g., spinal cord stimulator implantation). This elevated risk was most evident within the first few days after implantation, but remained elevated at all time points studied, including up to 1 year after implantation. There are many factors that likely contribute to this phenomenon, including patient comorbidities, surgical anesthetic, initiation of intrathecal therapy, priming bolus of highly concentrated drug, and concomitant medications. High-risk patients receiving intrathecal therapy should be closely monitored for serious side effects, especially during the initial postimplant period.