In this issue of the Scandinavian Journal of Pain we publish a second highly important article this year (2017) on the high efficacy and safety of intrathecal analgesia by the three experienced pain clinicians Lauri Kiehelä, Katri Hamunen, and Tarja Heiskanen at the Division of Pain Medicine at the Department of Anaesthesiology, Intensive Care and Pain Medicine in Helsinki . They report their successful results managing with spinal multimodal analgesia 60 patients with terminal cancer pain intractable with systemic opioids and co-medications . Mastenbroek and co-workers published a similar report on terminal cancer-patients with otherwise intractable pain who received successful intrathecal analgesia . These reports are observational studies in an area of pain and palliative medicine that cannot be studied with RCTs, i.e. traditional randomized and controlled studies, double blinded, with placebo or other active therapy .1Terminal cancer-patients suffering from pain that is intractable with high dose systemic opioids do better with intrathecal multimodal analgesiaThese two reports are extremely important because authoritative palliative care authors in 2015, finding no “evidence” from low quality RCTs, concluded that intraspinal analgesia with opioids should not be used for cancer-pain . This has resulted in therapeutic nihilism among some palliative care teams without
Scandinavian Journal of Pain – de Gruyter
Published: Jul 1, 2017
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