Faculty Articles

Title

Effects of Intrathecal Opioid Administration on Pituitary Function

ISBN or ISSN

1526-2375

Publication Title

Pain Medicine

Volume

14

Issue

11

Publication Date / Copyright Date

11-1-2013

First Page

1741

Last Page

1744

Publisher

Wiley

DOI Number

10.1111/pme.12205

Abstract

Objective

To report a case of panhypopituitarism in a patient receiving long‐term intrathecal opioids.

Design

This is a case study and review of current medical literature. There is a 7‐year follow‐up time.

Patients

One adult male clinic patient with pituitary dysfunction.

Main Outcome Measure(s)

Intrathecal opioids may lead to pituitary dysfunction.

Results

Intrathecal opioid pain management may produce some generalized effects, as well as pituitary hypofunction, as evidenced by this case. This patient experienced simultaneous suppression of multiple anterior pituitary hormones, which persisted with chronic oral opioid therapy following cessation of an intrathecal opioid pump.

Conclusions

All hypothalamic pituitary axes, seem potentially vulnerable to therapy with intrathecal opioids. When patients are receiving these medications, symptoms need to be critically evaluated with appropriate laboratory assessments for suspected pituitary dysfunction. Further studies are required in order to create formal recommendations for routine patient surveillance during intrathecal opioid therapy.

Disciplines

Medical Specialties | Medicine and Health Sciences | Osteopathic Medicine and Osteopathy

Keywords

chronic pain, opioids, pituitary function

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