Clinical guidelines for intraspinal infusion: Report of an expert panel

Consensus guidelines developed by an expert panel are helpful to clinicians when there is variation in practice and lack of a firm evidence base for a n intervention, such as intraspinal therapy for pain. An internet-based sur vey of practitioners revealed remarkable variation in practice patterns sur roundings intraspinal therapy. This prompted an interdisciplinary panel wit h extensive clinical experience in intraspinal infusion therapy to evaluate the results of the survey, the systematic reviews of the literature pertai ning to this approach, and their own clinical experience with long-term spi nal infusions. The panel proposed a scheme for the selection of drugs and d oses for intraspinal therapy, and suggested guidelines for administration t hat would increase the likelihood of a successful outcome. These expert pan el guidelines were designed to provide an initial structure for clinical de cision making that is based on the best available evidence and the prospect ives of experienced clinicians. (C) U.S. Cancer Pain Relief Committee, 2000 .