ziconotide and Ethmoid-Sinusitis

We report on the intrathecal use of ziconotide in three patients with idiopathic facial pain after surgery of the mouth, jaw or face and one patient with neuropathic pain after damage of the lingual nerve. The therapy was successful in three patients but one patient with idiopathic facial pain had pain relief only during the test phase of ziconotide with an external pump and not after implanting the Synchromed® pump. With intrathecal morphine therapy this patient achieved good pain relief. We recommend that patients with neuropathic facial pain should be treated with ziconotide after implementation of guideline-based therapy. In the test phase the ziconotide dose should be increased by 0.6 µg/day per week after an initial dose of 0.6-1.2 µg/day to avoid side-effects.

Topics: Adult; Analgesics, Non-Narcotic; Dose-Response Relationship, Drug; Ethmoid Sinusitis; Facial Neuralgia; Female; Humans; Infusion Pumps, Implantable; Injections, Spinal; Lingual Nerve Injuries; Maxillary Sinusitis; Mucocele; omega-Conotoxins; Pain Measurement; Pain, Postoperative; Tooth Extraction; Treatment Outcome; Trigeminal Neuralgia; Young Adult