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Spinal Opioid Infusion Deemed Probable Cause of Deaths

Last Updated: September 29, 2009.

An investigation into a cluster of deaths in patients being treated for non-cancer pain with intrathecal opioid pumps found that the pain relief therapy was the probable cause of death, according to a report in the October issue of Anesthesiology.

TUESDAY, Sept. 29 (HealthDay News) -- An investigation into a cluster of deaths in patients being treated for non-cancer pain with intrathecal opioid pumps found that the pain relief therapy was the probable cause of death, according to a report in the October issue of Anesthesiology.

Robert J. Coffey, M.D., of Medtronic Inc. in Minneapolis, and colleagues investigated nine cases, three of which formed the cluster of deaths that prompted the investigation, and a further six prospectively identified, to investigate the possible influence of patient-related and therapy-related differences in mortality rates.

The excess mortality in this group of patients could not be fully explained by any factors other than the use of intrathecal opioid therapy, the researchers found. The cause of death or major contributor to death was respiratory arrest in all patients, and this may have been a consequence of overdosage or drug interactions, although there were no device malfunctions that could lead to over-infusion, the investigators note.

"The exact causes for patient deaths and the proportion of those deaths attributable to intrathecal opioid therapy remain to be determined," the authors write. "These findings, although based on incomplete information, suggest that it may be possible to reduce mortality in non-cancer intrathecal opioid therapy patients."

The study was supported by Medtronic Inc., and several of the authors are employees of Medtronic.

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