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Recommendations from the Polyanalgesic Consensus Conference (PACC) on intrathecal drug infusion systems for cancer or other terminal condition-associated pain

Recommendations from the Polyanalgesic Consensus Conference (PACC) on intrathecal drug infusion systems for cancer or other terminal condition-associated pain
Localized nociceptive or neuropathic pain
Evidence strongest for:
Ziconotide
Morphine
Fentanyl
Hydromorphone
Morphine or fentanyl or hydromorphone plus bupivacaine
Morphine or fentanyl or hydromorphone plus clonidine
Morphine or fentanyl or hydromorphone plus ziconotide
Diffuse nociceptive or neuropathic pain
Evidence strongest for:
Ziconotide
Morphine
Hydromorphone
Morphine or hydromorphone plus clonidine
Morphine or hydromorphone plus bupivacaine
Morphine or hydromorphone plus ziconotide
Adapted from: Deer TR, Pope JE, Hayek SM, et al. The Polyanalgesic Consensus Conference (PACC): Recommendations on intrathecal drug infusion systems best practices and guidelines. Neuromodulation 2017; 20:96.
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