TY - CHAP M1 - Book, Section TI - Intrathecal Drug Delivery: An Overview of Modern Concepts in Advanced Pain Care A1 - Pope, Jason E. A1 - Deer, Timothy R. A2 - Bajwa, Zahid H. A2 - Wootton, R. Joshua A2 - Warfield, Carol A. PY - 2016 T2 - Principles and Practice of Pain Medicine, 3e AB - The concept of placement of drugs into the cerebral spinal fluid (CSF) to impact a patient's perception or sensation is not a novel concept. In the early 19th century scientists and physicians sought this route to impact health care. Early pioneers of this therapy can be traced back to the origins of spinal anesthesia, and many people are responsible for the current state of the art.1 In 1885, Corning performed the first “spinal block.” This was followed by August Bier in Germany, who was a self-volunteer for a spinal injection. In 1898, the first spinal anesthetic was documented using cocaine as the drug, followed in 1901 with the first epidural used for pain treatment. The use of corticosteroids for treatment of pain occurred in 1952. Development of newer agents slowed at this point, with no major advances until the 1980s when intrathecal morphine and intrathecal baclofen were approved for the treatment of chronic pain and spasticity, respectively.2 Ziconotide received US Food and Drug Administration (FDA) approval in 2004 as a non-opioid intrathecal alternative for treatment of pain. Current studies have been conducted on hydromorphone, gabapentin, octreotide, and new calcium channel blocking drugs, but no new positive reports have been noted. The history of intrathecal therapy has been shaped by a series of consensus conferences that have given guidance based on information provided by experts in the field. The history to be written in the next decade will most likely focus on new drugs and improved safety. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/20 UR - neurology.mhmedical.com/content.aspx?aid=1131938590 ER -