Patients often adhere to intrathecal opioid therapy (IOT) for many years, despite the lack of scientific evidence for its efficacy and the scarce knowledge about long-term effects. Moreover, there is no knowledge on how the efficacy of IOT is influenced by cultural factors. We assessed the long-term efficacy and frequency of side effects of IOT in two culturally different patient samples. A chart review was conducted of all patients with IOT, who had been treated in interdisciplinary pain centers in Freiburg and in Tehran in a 15-year span. Personal data, diagnosis, duration of pain disease, pump type in use, revision operations, and opioid doses were recorded. Patients completed a questionnaire containing pain scores, pain-related disability (PDI), anxiety, depression, and unwanted side effects. Fourteen Iranian and 36 German patients (32 m/18 f) were studied. Mean duration of IOT was 10.2 years. Pain levels prior to IOT were 7.64 (NRS) (range 4–10, SD 1.64), 3.86 (range 0–9, SD 2.32) directly after pump implantation, and 4.17 (range 0–10, SD 2.11) at time of follow-up. Iranian patients had significantly lower pain levels directly after implantation, depression scores, and pain-related disability. Frequent side effects were obstipation, sexual dysfunction, urinary retention, and fatigue. Most side effects were significantly less frequent in the Iranian sample. There were no severe complications or permanent neurological deficit. Our study demonstrates the effectiveness of IOT also for long-term application. Differences in clinical efficacy are partially due to cultural factors. Side effects are frequent but not limiting patient satisfaction.

患者通常坚持鞘内阿片类药物治疗 (IOT) 多年，尽管缺乏关于其疗效的科学证据和关于长期影响的稀缺知识。此外，没有关于物联网的功效如何受文化因素影响的知识。我们在两个文化不同的患者样本中评估了 IOT 的长期疗效和副作用的频率。对所有 IOT 患者进行了图表审查，这些患者曾在弗莱堡和德黑兰的跨学科疼痛中心接受了 15 年的治疗。记录个人数据、诊断、疼痛疾病持续时间、使用的泵类型、修正操作和阿片类药物剂量。患者完成了一份包含疼痛评分、疼痛相关残疾 (PDI)、焦虑、抑郁和不良副作用的问卷。研究了 14 名伊朗患者和 36 名德国患者 (32 m/18 f)。物联网的平均持续时间为 10.2 年。IOT 前的疼痛水平为 7.64 (NRS)（范围 4-10，SD 1.64），泵植入后直接为 3.86（范围 0-9，SD 2.32），随访时为 4.17（范围 0-10，SD 2.11） -向上。伊朗患者在植入后直接疼痛水平、抑郁评分和疼痛相关残疾显着降低。常见的副作用是便秘、性功能障碍、尿潴留和疲劳。大多数副作用在伊朗样本中的频率明显较低。没有严重并发症或永久性神经功能缺损。我们的研究证明了物联网对于长期应用的有效性。临床疗效的差异部分是由于文化因素。