Internal medicine

Receptor

Organic chemistry

Adverse effect

Agonist

Intensive care medicine

Intrathecal

Chemistry

Morphine

Opioid

Fentanyl

Clonidine

Spasticity

Hydromorphone

Drug delivery

Drug

Baclofen

Anesthesia

Medicine

Pharmacology

BJA Education

Intrathecal drug delivery is an invasive treatment for the management of therapy-resistant pain, spasticity and dystonia not controlled by oral drug therapy. This form of delivery is based on the premise that effective treatment can be achieved by administering a low volume of drugs near to the site of action, thus reducing the incidence and severity of adverse effects. High systemic doses of drugs are required to achieve the same concentrations. On-label drugs used include morphine, baclofen and ziconotide, but the use of off-label drugs such as hydromorphone, clonidine, fentanyl and mixtures of different drugs are used frequently.

Complications associated with intrathecal drug delivery systems