Intracerebroventricular opiate infusion for refractory head and facial pain

Table 1 Patient characteristics and outcomes

Patient	Age (at pump placement, yr)	Gender	Primary diagnosis	Prior surgeries	Pre-implant-ation trial	ICV pump medication	Initial dose (mg/d)	Final dose (mg/d)	Pre-opVAS	Post-opday 1 VAS	LastVAS	Last post-op visit (mo)
1	67	Male	Trigeminal neuralgia (left)		Ommaya reservoir- morphine	Morphine then dilaudid	0.1 morphine	3.27 dilaudid	6	3.5	4	145
2	35	Female	Cluster headaches		Ommaya reservoir- morphine	Morphine	0.65 morphine	19.0 morphine	8	4	0	166
3	37	Female	Trigeminal neuralgia (right), Cluster headaches		Ommaya reservoir- morphine, dilaudid	Dilaudid	0.1 dilaudid	0.2 dilaudid	8	2.5	3	9
4	74	Male	Trigeminal neuralgia (left)	Rhizotomy, Microvascular decompression	Ommaya reservoir- morphine	Morphine	0.75 morphine	1.75 morphine	8	1	1	10
5	62	Female	Trigeminal neuralgia (right)	Microvascular decompression	Ommaya reservoir- morphine	Morphine	4 morphine	4.25 morphine	10	3	2	3
6	79	Female	Trigeminal neuralgia (left)	Meningioma resection (left), radiosurgery ×2	External ventricular drain-morphine, dilaudid	Dilaudid	0.01 dilaudid	0.085 dilaudid	8	2	2	15

VAS: Visual analogue scale; ICV: Intracerebroventricular.

Table 2 Dose ranges and complications

Patient	Dose range (mg/d)	Complications
1	0.10-21.5 (morphine)	Nausea/Emesis (transient-decreased dosage)
	2.10-3.27 (dilaudid)	Changed medication due to inadequate pain control/nausea
2	0.65-19.0 (morphine)	Replacement of pump × 2 (q5 yr)
		Withdrawal symptoms (transient)
3	0.20 (dilaudid)	Psychiatric disturbances leading to removal of pain pump after 11 yr
4	0.75-2.0 (morphine)	Nausea/ Emesis (transient- decreased dosage)
5	4.00-4.25 (morphine)	Lost to follow-up after 1 yr
6	0.01–0.10 (dilaudid)