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Intrathecal pump

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https://www.readbyqxmd.com/read/29446171/retrospective-analysis-of-intrathecal-drug-delivery-outcomes-efficacy-and-risk-for-cancer-related-pain-at-a-high-volume-academic-medical-center
#1
Dawood Sayed, Forrest Monroe, Walter N Orr, Milind Phadnis, Talal W Khan, Edward Braun, Smith Manion, Andrea Nicol
OBJECTIVES: Cancer pain is common and difficult to treat, as conservative medical management fails in approximately 20% of patients for reasons such as intolerable side-effects or failure to control pain. Intrathecal drug delivery systems (IDDS), while underutilized, can be effective tools to treat intractable cancer pain. This study aims to determine the degree of pain relief, efficacy, and safety of patients who underwent IDDS implantation at a multidisciplinary pain clinic. MATERIALS AND METHODS: A retrospective review was conducted of patients with an intrathecal pain pump implanted for malignant pain...
February 14, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29372855/placement-of-baclofen-pump-catheter-through-a-c1-2-puncture-technical-note
#2
Zaid Aljuboori, Jacob Archer, Wei Huff, Amee Moreno, Andrew Jea
Intrathecal baclofen has been suggested as an effective and safe treatment for intractable spasticity and dystonia. Techniques of lumbar and intraventricular catheter placement have been previously described. The purpose of this study was to describe a technique to implant catheters for intrathecal baclofen infusion through C1-2 puncture. Four of 5 consecutively treated patients underwent successful placement of catheters for intrathecal baclofen. There were no instances of infection, CSF leak, or catheter migration seen during a follow-up period of at least 6 months; furthermore, there were no occurrences of vertebral artery or spinal cord injury...
January 26, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29372853/a-standardized-protocol-to-reduce-pediatric-baclofen-pump-infections-a-quality-improvement-initiative
#3
Virendra R Desai, Jeffrey S Raskin, Arvind Mohan, JoWinsyl Montojo, Valentina Briceño, Daniel J Curry, Sandi Lam
OBJECTIVE Intrathecal baclofen pumps are generally placed in children for the treatment of spasticity and dystonia. Use of implants in this pediatric population with comorbidities is reported to have a high risk of complications and infections. With the aim of reducing baclofen pump-related infections, a quality improvement project was instituted at the authors' institution. METHODS A workflow paradigm unique to baclofen pump implantation aimed at decreasing implant-related infections was implemented. All baclofen pump operations performed at the authors' institution between August 2012 and June 2016 were reviewed...
January 26, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29369202/palliative-care-with-cervical-intrathecal-infusion-and-external-pump-for-a-late-stage-cancer-patient-with-refractory-pain-a-case-report
#4
Yanxin Ju, Demin Tian, Yanqin Tan, Zhijian Fu
RATIONALE: Intrathecal therapy, with a low complication rate, has become an alternative to standard pain management for treatment of neuropathic cancer pain. PATIENT CONCERNS: Here, we reported a late-stage cancer patient with intractable neuropathic pain in his right neck, shoulder, and upper limb. DIAGNOSES: The pain started 2 years ago when the patient was diagnosed as squamous cell carcinoma with metastasis to right supraclavicular lymph nodes...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29366919/treatment-of-post-anoxic-action-myoclonus-with-intrathecal-baclofen-a-case-report
#5
James A Whitlock, Ryan W Dumigan
A case of severe action myoclonus following pulmonary arrest is described. Although there was benefit from oral pharmacotherapy, action myoclonus remained disabling. A favorable response to baclofen during an intrathecal trial led to eventual placement of an intrathecal baclofen pump. The present case illustrates the potential utility of intrathecal baclofen for treating this condition.
January 20, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29351050/hidden-medical-devices-in-the-school-setting-what-the-school-nurse-needs-to-know-about-the-safe-use-of-baclofen-pumps
#6
Barbara Obst, Megan Roesler
One of the "hidden" medical devices in the school setting is the baclofen pump, which is used for the treatment of spasticity. The goals of spasticity treatment are to decrease muscle tone, deformity, and pain in order to maximize function and ease of care for both child and caregiver. The use of an intrathecal baclofen pump, often for children with cerebral palsy, spinal cord injury, brain injury, or stroke, has been effective in spasticity treatment. It is important for school nurses to be aware of the safety implications associated with this type of device...
January 1, 2018: NASN School Nurse
https://www.readbyqxmd.com/read/29349778/intrathecal-baclofen-therapy-in-children-an-analysis-of-individualized-goals
#7
Peck Yee Liew, Kirsty Stewart, Debra Khan, Sarah Jane Arnup, Adam Scheinberg
AIM: To determine whether intrathecal baclofen (ITB) therapy improves performance and performance satisfaction in goal areas identified by patients' parents. METHOD: This study formed part of an ongoing multicentre national audit involving six paediatric ITB pump implant centres across Australia. The Canadian Occupational Performance Measure was the primary outcome measure utilized at baseline, 6 months, and 12 months after pump implants in paediatric patients receiving ITB therapy for the first time between 31st December 2009 and 31st December 2014...
January 19, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29311456/-a-survey-of-the-adverse-effects-and-influence-of-concomitant-drugs-for-methotrexate-intrathecal-administration
#8
Masanobu Uchiyama, Miho Ueno, Yasushi Takamatsu, Koichi Matsuo, Osamu Imakyure, Hidetoshi Kamimura
 In general, the intraventricular administration of cytotoxic antitumor drugs provides a high drug concentration in the cerebrospinal fluid with a reduced risk of systemic adverse reactions. Methotrexate (MTX) high-dose therapy requires close monitoring when performed in combination with trimethoprim-sulfamethoxazole (ST) therapy and proton pump inhibitor (PPI) and nonsteroidal anti-inflammatory drug administration for excretion delay and toxicity enhancement. While the frequency of systemic side effects is thought to be low with intrathecal administration, such effects do rarely but occasionally occur...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29285413/minimally-invasive-repair-of-a-pseudomeningocele-caused-by-a-sheared-intrathecal-catheter-following-implantation-of-a-drug-delivery-system
#9
S Raju, P O Champagne, L Walsh, Daniel J Denis
Background: Shearing of an intrathecal catheter during implantation of a drug delivery system is an underreported complication that can be challenging to manage. Case Description: A 53-year-old man with refractory cancer pain had an intrathecal pump system implanted. The procedure was complicated with catheter shear and retention in the intrathecal space. A second catheter was successfully placed but formation of a painful pseudomeningocele and ineffective pain relief complicated the outcome...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29240019/integrating-patient-controlled-analgesia-using-implanted-intrathecal-pumps-for-postoperative-pain-management-a-case-report
#10
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
December 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#11
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29206310/ease-of-fill-port-access-during-the-ultrasound-guided-vs-the-blind-refill-technique-of-intrathecal-drug-delivery-systems-with-a-raised-septum-a-prospective-comparison-study
#12
Paolo Maino, Sander M J van Kuijk, Roberto S G M Perez, Eva Koetsier
OBJECTIVES: The localization of the reservoir fill port of Intrathecal Drug Delivery Devices (IDDS) can be difficult. The purpose of this study was to assess the ease of fill port access during the ultrasound-guided refill technique compared to the blind refill technique in IDDSs with a raised septum on the pump surface. MATERIALS AND METHODS: Written informed consent was obtained from 19 adult patients undergoing regular refills of their Raised Septum IDDSs (RS-IDDSs)...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29205982/spasticity-or-periodic-limb-movements
#13
Jonathan Levy, Sarah Hartley, Elsa Mauruc-Soubirac, Antoine Leotard, Frederic Lofaso, Maria-Antonia Quera-Salva, Djamel Bensmail
BACKGROUND: Spasticity and spasms are distressing features of the upper motor neuron syndrome (UMNS) following spinal cord injuries (SCI) or multiple sclerosis (MS), and have common therapeutic implications. Despite an increase of antispastic drugs and strategies, sometimes up to the surgical implant of intrathecal baclofen pump, some patients still complain of disabling spasms, which poses diagnostic and therapeutic challenges. Although clinically similar, flexor spasms due to pyramidal tract disruption must be clearly differentiated from periodic limb movements (PLM), often accompanying restless leg syndrome (RLS) and occurring during sleep...
December 4, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29174241/a-novel-skin-and-fascia-opening-for-subfascial-inserting-of-intrathecal-baclofen-pump
#14
P Fiaschi, A Cama, G Piatelli, P Moretti, M Pavanello
No abstract text is available yet for this article.
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29123622/retrospective-analysis-of-the-financial-break-even-point-for-intrathecal-morphine-pump-use-in-korea
#15
Eun Kyoung Kim, Ji Yeon Shin, Anyela Marcela Castañeda, Seung Jae Lee, Hyun Kyu Yoon, Yong Chul Kim, Jee Youn Moon
Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29115915/neuromodulation-in-multiple-sclerosis
#16
Hesham Abboud, Eddie Hill, Junaid Siddiqui, Alessandro Serra, Benjamin Walter
Neuromodulation, or the utilization of advanced technology for targeted electrical or chemical neuronal stimulation or inhibition, has been expanding in several neurological subspecialties. In the past decades, immune-modulating therapy has been the main focus of multiple sclerosis (MS) research with little attention to neuromodulation. However, with the recent advances in disease-modifying therapies, it is time to shift the focus of MS research to neuromodulation and restoration of function as with other neurological subspecialties...
November 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29101071/subarachnoid-to-subarachnoid-shunt-for-correction-of-nonfunctioning-baclofen-pump-in-a-severe-case-of-chronic-debilitating-post-spinal-cord-injury-spasticity
#17
Adewale A Bakare, Jonathan Weyhenmeyer, Albert Lee
BACKGROUND AND IMPORTANCE: Perhaps the most disabling condition seen in patients with spinal cord injury is spasticity. Spasticity is characterized as hyperreflexia and hypertonicity as a result of damage to the supraspinal tracts in the aftermath of SCI. Intrathecal baclofen (ITB) is the mainstay therapy for spasticity unresponsive to oral baclofen. One of the problems associated with post-SCI spasticity unresponsive to ITB is development of scar tissue that prevents the diffusion of baclofen in the desired spinal cord area...
October 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29079488/generalized-itching-and-lower-extremity-spasticity-in-a-patient-with-intrathecal-baclofen-pump
#18
Motunrayo Mobolaji-Lawal, Rittik Chaudhuri, Regan H Marsh, Emily S Miller, Kriti Bhatia
No abstract text is available yet for this article.
October 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29054133/effects-of-intrathecal-injection-of-the-conditioned-medium-of-bone-marrow-stromal-cells-on-spinal-cord-injury-of-rats
#19
Kenji Kanekiyo, Tamami Wakabayashi, Norihiko Nakano, Yoshihiro Yamada, Masahiro Tamachi, Yoshihisa Suzuki, Masanori Fukushima, Fukuki Saito, Seiya Abe, Chihiro Tsukagoshi, Chimi Miyamoto, Chizuka Ide
Bone marrow stromal cells (BMSCs) have been studied for the treatment of spinal cord injury (SCI). In previous studies, we showed that the transplantation of BMSCs, even though they disappeared from the host spinal cord within 1-3 weeks after transplantation, improved locomotor behaviors and promoted axonal regeneration. This result led to the hypothesis that BMSCs might release some neurotrophic factors effective for the treatment of SCI. The present study examined this by injecting the conditioned medium (CM) of BMSCs to treat SCI in rats...
October 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29050720/does-intrathecal-baclofen-therapy-increase-prevalence-and-or-progression-of-neuromuscular-scoliosis
#20
Kevin R Walker, Susan A Novotny, Linda E Krach
STUDY DESIGN: Retrospective, case-matched review. OBJECTIVES: Compare a group of individuals with cerebral palsy (CP) who had intrathecal baclofen (ITB) pumps to a group of individuals with CP who did not have ITB pumps in order to determine if there was a difference in the prevalence of new-onset neuromuscular scoliosis, an increased rate of progression of preexisting neuromuscular scoliosis, or an increased rate of posterior spine fusion surgery in skeletally immature individuals with CP who had ITB pumps...
November 2017: Spine Deformity
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