Background and aim: The aim of this study was to evaluate the efficacy and safety of long-term administration of different doses of morphine, baclofen, fentanyl, clonidine and ropivacaine via implanted intrathecal pumps for the treatment of persistent chronic pain and spasticity.
Material and method: Eighty patients were included in the study. All were suffered from chronic pain with VAS > 6 after administration of high oral doses of opioids, antidepressant and antiepileptic drugs or they had a spasticity greater than 2/5 of the Ashworth scale. Assessment of pain, spasticity and quality of life was performed 15 and 30 days after implantation and for a 15 months period. We also recorded the doses of morphine, fentanyl, baclofen, clonidine and ropivacaine.
Results: Forty-four male and 36 women were enrolled. There was a statistically significant reduction in pain score in 15 days after implantation (VAS 7,34 vs 5,32(p< 0.001), while the mean value of Asworth scale was reduced from 3,70 to 2,52 (p< 0.001) and the mean value of APCA scale increases from 4,2 to 7,35(p< 0.001), showing reduction of spasticity and a better quality of life.
Mean VAS score in 15 months was 3 while in first month was 5. The changes in Asworth scale were relatively stable with a mean value 2.
Conclusions: The co-administration of different doses of morphine, baclofen, fentanyl, clonidine and ropivacaine results in a significant reduction of pain, better quality of life and significant reduction of spasticity in comparison to the monotherapies.

EFFICACY AND SAFETY OF LONG-TERM ADMINISTRATION OF DIFFERENT AGENTS VIA IMPLANTED INTRATHECAL PUMPS FOR THE TREATMENT OF PERSISTENT CHRONIC PAIN AND SPASTICITY