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Intrathecal pump

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https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#1
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28406070/an-investigation-of-the-relationship-between-autonomic-dysreflexia-and-intrathecal-baclofen-in-patients-with-spinal-cord-injury
#2
Anna Sophia Del Fabro, Melvin Mejia, Gregory Nemunaitis
OBJECTIVE: To study the relationship between autonomic dysreflexia and intrathecal baclofen in patients with spinal cord injury. DESIGN: Retrospective chart review. SETTING: Inpatient and outpatient acute rehabilitation facility. PARTICIPANTS: Thirty-four subjects. INTERVENTIONS: We reviewed patients' medical records to ascertain the presence of symptomatic autonomic dysreflexia (AD) prior to and after implantation of an intrathecal baclofen (ITB) pump for spasticity in spinal cord injury patients...
April 13, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28393436/intrathecal-pump-refills-pocket-fills-and-symptoms-of-drug-overdose-a-prospective-observational-study-comparing-the-injected-drug-volume-vs-the-drug-volume-effectively-measured-inside-the-pump
#3
Paolo Maino, Roberto S G M Perez, Eva Koetsier
OBJECTIVES: One complication associated with the refill procedure of intrathecal drug delivery systems (IDDSs) include a "pocket fill," which is the inadvertent injection of the drug into the subcutaneous space surrounding the pump. The purpose of our study was to assess the mean volume discrepancy between the injected and the effective drug volume inside the IDDS reservoir after refills that did not lead to signs of overdose and to record at which volume discrepancy symptoms of overdose were noticed...
April 10, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28368941/continuous-ropivacaine-subfascial-wound-infusion-compared-with-intrathecal-morphine-for-postcesarean-analgesia-a-prospective-randomized-controlled-double-blind-study
#4
Manon Lalmand, Madeleine Wilwerth, Jean-François Fils, Philippe Van der Linden
BACKGROUND: After cesarean delivery, postoperative pain management allows early rehabilitation and helps prevent postpartum depression and chronic pain. Our present prospective, randomized controlled, double-blind study assessed the duration and effect of intrathecal analgesia and continuous ropivacaine wound infiltration versus a control group after cesarean delivery. The primary outcome was analgesia duration, defined as time to first morphine request. Secondary outcomes were cumulative postoperative morphine consumption, number of patients who did not require IV morphine, incidence of adverse effects, and time to first ambulation...
March 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28353527/baclofen-pumps-uses-and-complications
#5
Seth M Woolf, Carl R Baum
Intrathecal baclofen therapy, given via an implanted pump in the abdominal wall either as a continuous infusion or bolus dosing, has been used for more than 25 years to treat the spasticity and dystonia associated with various brain and spinal cord conditions. Pediatric clinicians occasionally encounter baclofen pumps, and in the pediatric setting, significant morbidity can arise from their use. This article presents the background, mechanism of action, uses, and complications of intrathecal baclofen therapy and discusses various management strategies should complications occur...
April 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28326948/rare-presentation-of-intrathecal-morphine-withdrawal-psychosis
#6
Rohit Aiyer, Vivek Jain, Anurag Bhatia, Boris Mekinulov, Semih Gungor
We report a case of a 57-year-old male patient with intrathecal morphine pump failure who presented with psychosis as part of a clinical presentation of opioid withdrawal. The patient was being treated for chronic back pain with an intrathecal morphine pump for several years. The patient spontaneously started to experience psychotic symptoms which included disorganized thinking, delusional thoughts, paranoia, auditory and visual hallucinations. Upon interrogation of intrathecal pump, it was found not to be functioning, thereby not delivering intrathecal morphine...
February 28, 2017: Pain Management
https://www.readbyqxmd.com/read/28296770/evaluation-of-intrathecal-drug-delivery-system-for-intractable-pain-in-advanced-malignancies-a-prospective-cohort-study
#7
Shuyue Zheng, Liangliang He, Xiaohui Yang, Xiuhua Li, Zhanmin Yang
Pain is prevalent in advanced malignancies; however, some patients cannot get adequate pain relief by conservative routes of analgesic administration or experience serious side effects related to high dose of opioids. For those who have exhausted multimodal conservative analgesic, intrathecal drug delivery is an alternative intervention for truly effective pain management. The objective of this study was to evaluate the clinical efficacy and safety of intrathecal drug delivery system (IDDS) for the treatment of intractable pain in advanced cancer patients...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28291215/-complications-of-intrathecal-baclofen-therapy
#8
D L Paskhin, A V Dekopov, A A Tomsky, E D Isagulyan, E M Salova
AIM: To analyze complications of intrathecal baclofen therapy and identify high-risk groups. MATERIAL AND METHODS: We implanted 52 pumps to spastic patients for chronic intrathecal baclofen infusion. Two groups of patients were distinguished: 23 patients with spinal spasticity (group 1) and 29 patients with cerebral spasticity (group 2). The mean patient age was 37.2±14.6 years in group 1 and 17.3±10.3 years in group 2. Surgery was performed according to a standard procedure...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28257279/intrathecal-baclofen-therapy-for-the-treatment-of-spasticity-in-sj%C3%A3-gren-larsson-syndrome
#9
Eveline Teresa Hidalgo, Cordelia Orillac, Andrew Hersh, David H Harter, William B Rizzo, Howard L Weiner
Intrathecal baclofen therapy is widely accepted as a treatment option for patients with severe spasticity. The current treatment of spasticity in patients with Sjögren-Larsson syndrome is largely symptomatic, given that no effective causal therapy treatments are available. We report the outcome of 2 patients with Sjögren-Larsson syndrome who had pump implantation for intrathecal baclofen. We observed a positive response, with a decrease of spasticity, reflecting in the Modified Ashworth Scale, and parents and caregivers observed a functional improvement in both patients...
January 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28237420/long-term-therapy-with-intrathecal-baclofen-improves-quality-of-life-in-children-with-severe-spastic-cerebral-palsy
#10
Tanja Kraus, Kathrin Gegenleitner, Martin Svehlik, Michael Novak, Gerhardt Steinwender, Georg Singer
INTRODUCTION: Children with severe spastic cerebral palsy (CP) are highly limited in daily life activities causing a reduced quality of life (QoL). This is partly due to an increased muscle tone causing pain and contractures. Continuous intrathecal infusion of baclofen (ITB) reduces the spasticity of affected patients. The hypothesis of the present study was that ITB leads to a significant improvement of QoL in non-ambulant children with CP. PATIENTS AND METHODS: 13 patients (10 male, 3 female, mean age 14 years) were included...
February 11, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28202830/-usefulness-of-bolus-administration-using-the-flex-mode-bolus-infusion-mode-for-baclofen-tolerance
#11
Kazunori Tanaka
Intrathecal baclofen(ITB)is used to treat intractable spasticity of various etiologies and can provide better control of spasticity through the adjustment of the dose administered through the pump. However, in patients who develop tolerance to baclofen with the standard simple continuous mode, a sharp increase in dose becomes necessary, and spasticity can become harder to control. We investigated whether switching from the simple continuous mode to the bolus infusion mode was effective in controlling spasticity in patients with baclofen tolerance...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28195861/perioperative-management-of-a-patient-with-an-intrathecal-drug-delivery-device-infusing-ziconotide-a-case-report
#12
Sephalie Patel, Osama Hafez, Wade J Sexton, David A Edwards
Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug delivery device infusing ziconotide in a patient presenting for radical cystectomy with pelvic lymphadenectomy and ileal conduit diversion...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28162657/-412-patient-with-altered-mental-status-an-intrathecal-pump-and-an-unknown-dose-of-ziconotide
#13
K Noon, T Furnish
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#14
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156208/image-guided-intrathecal-baclofen-pump-catheter-implantation-a-technical-note-and-case-series
#15
Shenandoah Robinson, Faith C Robertson, Hormuzdiyar H Dasenbrock, Cormac P O'Brien, Charles Berde, Horacio Padua
OBJECTIVE Medically refractory spasticity and dystonia are often alleviated with intrathecal baclofen (ITB) administration through an indwelling catheter inserted in the lumbar spine. In patients with cerebral palsy, however, there is a high incidence of concomitant neuromuscular scoliosis. ITB placement may be technically challenging in those who have severe spinal deformity or who have undergone prior instrumented thoracolumbar fusion. Although prior reports have described drilling through the lumbar fusion mass with a high-speed bur, as well as IT catheter implantation at the foramen magnum or cervical spine, these approaches have notable limitations...
February 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28101564/changes-in-body-composition-after-spasticity-treatment-with-intrathecal-baclofen
#16
Olle Skogberg, Kersti Samuelsson, Per Ertzgaard, Richard Levi
OBJECTIVE: To assess changes in body composition, body weight and resting metabolic rate in patients who received intrathecal baclofen therapy for spasticity. DESIGN: Prospective, longitudinal, quasi-experimental, with a pre/post design. PATIENTS: Twelve patients with spasticity, fulfilling study criteria, and due for pump implantation for intrathecal baclofen therapy, completed the study. METHODS: Data were obtained before, 6 months and 12 months after commencement of intrathecal baclofen therapy as regards body composition (by skinfold calliper), body weight, and resting metabolic rate (by resting oxygen consumption)...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28100863/-utility-of-intraoperative-catheter-myelography-during-intrathecal-baclofen-pump-implantation-report-of-2-cases
#17
Soichiro Takamiya, Toru Sasamori, Shuji Hamauchi, Toshitaka Seki, Takahiro Kano, Ichiro Yabe, Hidenao Sasaki, Kiyohiro Houkin
We report two patients in whom the intrathecal baclofen(ITB)catheter was located in the subdural space, although we had confirmed good outflow of spinal fluid from the spinal catheter. Patient 1 was a woman in her 30s with spastic quadriplegia due to subarachnoid hemorrhage. An ITB pump was implanted, and a good outflow of spinal fluid from the spinal catheter was observed during the surgery. Postoperatively, her spasticity did not improve. Catheter myelography revealed that the spinal catheter was located in the subdural space...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28100860/-a-pediatric-case-of-intractable-cerebrospinal-fluid-leakage-after-implantation-of-an-intrathecal-baclofen-pump
#18
Akitsugu Morishita, Hideo Aihara, Tomoaki Nakai, Masao Adachi
Intrathecal baclofen(ITB)infusion can offer a useful treatment for severe spasticity;however, numerous complications have been reported. We report a pediatric case in which intractable cerebrospinal fluid(CSF)leakage associated with several inconvenient symptoms arose after implantation of the ITB pump system. A 10-year-old girl with spastic quadriparesis and athetoid cerebral palsy underwent implantation of an ITB delivery system. After discharge, she presented with fluid collection surrounding the pump in the abdomen...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28025375/intrathecal-therapy-for-cancer-related-pain
#19
REVIEW
Brian M Bruel, Allen W Burton
OBJECTIVE: The increasing incidence of cancer survivorship has shifted treatment of cancer-related pain from short-term analgesia to long-term chronic pain management. As a result, alternatives to oral analgesics, such as intrathecal therapy, may be beneficial for patients with cancer-related pain. The authors review the use of intrathecal therapy in the management of cancer-related pain. METHODS: The Medline database was searched for English-language articles that included "ziconotide" or "morphine" AND ("cancer" OR "malignant") AND "intrathecal" in title or abstract...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28008298/severe-protracted-spasm-of-urinary-bladder-and-autonomic-dysreflexia-caused-by-changing-the-suprapubic-catheter-in-a-cervical-spinal-cord-injury-patient-treatment-by-a-bolus-dose-and-increased-total-daily-dose-of-intrathecal-baclofen
#20
Subramanian Vaidyanathan, Tun Oo, Bakul M Soni, Peter L Hughes, Gurpreet Singh
BACKGROUND: Intrathecal administration of baclofen by implanted pump reduces rigidity and muscle spasms. Its use specifically to control bladder spasms has not been reported. CASE REPORT: A tetraplegic patient developed severe, protracted, bladder spasms, abdominal muscles spasms, and high blood pressure after change of suprapubic catheter; nifedipine, diazepam, and paracetamol did not control spasms; bolus dose of baclofen intrathecally produced prompt relief via baclofen pump...
2016: Clinical Medicine Insights. Case Reports
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