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Personalized Intrathecal Drug Delivery: Models, Targets, and Approaches

Wanderer, Jonathan P. MD, MPhil; Nathan, Naveen MD

doi: 10.1213/ANE.0000000000002081
Infographics: Infographic

Vanderbilt University School of Medicine (

Northwestern University Feinberg School of Medicine (

The Infographic is composed by Jonathan P. Wanderer, MD, MPhil, Vanderbilt University School of Medicine (, and Naveen Nathan, MD, Northwestern University Feinberg School of Medicine (

Illustration by Naveen Nathan, MD.

While delivering medications through the intrathecal route can be effective for providing pain relief with fewer side effects, limited resources are available to guide selection of drug and pump settings. Understanding the contribution of variability in patient anatomy to drug delivery may be essential to optimizing intrathecal administration. In this infographic, we describe progress using in silico and in vitro simulation for determining optimal intrathecal drug delivery.1

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1. Tangen KM, Leval R, Mehta AI, Linninger AA. Computational and in vitro experimental investigation of intrathecal drug distribution: parametric study of the effect of injection volume, cerebrospinal fluid pulsatility, and drug uptake. Anesth Analg2017;124:1686–1696.
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