Effects of Intrathecal Opioid Administration on Pituitary Function

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. © 2013 Wiley Periodicals, Inc.