Outcome of continuous intrathecal opioid therapy for management of chronic pain in Iranian veterans of the imposed Iraq-Iran war

ABSTRACT

Among patients with chronic unrelieved pain, war veterans of eight years long Iraq-Iran war deserve especial attention. They not only suffer from severe intractable pain but also should bear some intangible consequences of unrelieved pain and severe disability. This perspective study reviews the outcome of implantation of intrathecal opioid pumps in these patients. Ten war veterans [mean age 43.36] with chronic nonmalignant pain included in this perspective study. Medical records reviewed to identify pain diagnosis, medication intake prior to implantation, details of the intrathecal opioid trial and date of implantation, surgical and technical complications. Outcome measures were global pain relief, physical activity levels, intrathecal opioid side effects, medication consumption and patient satisfaction. Overall pain relief at the time of study was 60%. Mean pain relief was 53%. A majority of patients reported improvements in physical activity levels and were satisfied with this type of therapy. Impotence and constipation were two most common pharmacological side effects. No surgical complication reported. The study showed that this type of therapy in Iranian war veterans improved analgesia, increased self-report physical activity levels and in spite of high incidence of pharmacological side effects, most of the patients were satisfied with this type of therapy. These results are comparable to those of previous studies in this field