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Intrathecal pain pump

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https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#1
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29747017/a-novel-association-between-intrathecal-drug-administration-and-arachnoiditis-ossificans
#2
Max Ward, Antonios Mammis, Maureen T Barry, Robert F Heary
We present a case of delayed progression of adhesive arachnoiditis to arachnoiditis ossificans (AO) in a patient being treated with a high dose polypharmaceutical intrathecal regimen. The patient is a 39-year-old Caucasian male who was implanted with an intrathecal pump in 2006 to control severe low back pain and administered intrathecal pain medication for a period of 10 years. In 2016, he developed new onset radicular pain and worsened sensation in his lower extremities. A CT scan of the lumbar spine at that time demonstrated profound calcification of the arachnoid consistent with a diagnosis of AO...
May 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29729779/interventional-anesthetic-methods-for-pain-in-hematology-oncology-patients
#3
REVIEW
Holly Careskey, Sanjeet Narang
This article reviews anesthetic interventional approaches to the management of pain in hematology and oncology patients. It includes a discussion of single interventions including peripheral nerve blocks, plexus injections, and sympathetic nerve neurolysis, and continuous infusion therapy through implantable devices, such as intrathecal pumps, epidural port-a-caths, and tunneled catheters. The primary objective is to inform members of hematology and oncology care teams regarding the variety of interventional options for patients with cancer-related pain for whom medical pain management methods have not been effective...
June 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29570548/intrathecal-baclofen-therapy-prior-to-spinal-fusion-for-patients-with-gross-motor-function-classification-system-iv-v-cerebral-palsy
#4
Kristin Buxton, Rachel Difazio, Ann Morgan, Margaret McCabe, Peter W Forbes
BACKGROUND: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB therapy on the postoperative course following spinal fusion in patients with GMFCS IV-V CP has not been described. This study sought to compare postoperative recovery, including complications, in patients using ITB therapy with those with no ITB therapy...
March 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29543644/intrathecal-drug-delivery-systems-for-refractory-pancreatic-cancer-pain-observational-follow-up-study-over-an-11-year-period-in-a-comprehensive-cancer-center
#5
Gabriel Carvajal, Denis Dupoiron, Valerie Seegers, Nathalie Lebrec, François Boré, Pierre-Yves Dubois, Damien Leblanc, Thierry Delorme, Sabrina Jubier-Hamon
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death in Europe and the United States. Studies have demonstrated that patients with pancreatic cancer have a high prevalence of pain, with rates varying from 47% to 82%. Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. METHODS: The IDDS for pancreatic cancer pain was a follow-up observational study designed to evaluate 11-year results of IDDS for refractory pancreatic cancer pain at the Institut de Cancérologie de L'Ouest, Paul Papin in France...
March 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29478715/validated-chromatographic-method-for-the-simultaneous-determination-of-eight-drugs-morphine-ropivacaine-bupivacaine-baclofen-clonidine-sufentanil-fentanyl-and-ziconotide-for-intrathecal-analgesia
#6
J Sorrieul, J Robert, V Gibory, M Collet, M Boutet, H Kieffer, C Folliard, D Dupoiron, C Devys
Intrathecal analgesia has increased over the past two decades in various indications: chronic refractory pain from cancerous or non-cancerous origins, spasticity. These different indications involve the use of different molecules alone or in combination such as morphine, ropivacaine, bupivacaine, fentanyl, sufentanil, clonidine, baclofen and ziconotide. Pump refills are prepared at the pharmacy under a laminar flow hood. An analytical control should be carried out before release of the preparation. A new method of analytical control by chromatography has been developed and validated according to the International Conference on Harmonization guideline in order to secure the production process...
May 2018: Annales Pharmaceutiques Françaises
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
#7
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/29369202/palliative-care-with-cervical-intrathecal-infusion-and-external-pump-for-a-late-stage-cancer-patient-with-refractory-pain-a-case-report
#8
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/29351050/hidden-medical-devices-in-the-school-setting-what-the-school-nurse-needs-to-know-about-the-safe-use-of-baclofen-pumps
#9
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...
March 2018: NASN School Nurse
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
#10
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
#11
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
#12
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...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29123622/retrospective-analysis-of-the-financial-break-even-point-for-intrathecal-morphine-pump-use-in-korea
#13
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
#14
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/29016893/efficacy-safety-and-feasibility-of-the-morphine-microdose-method-in-community-based-clinics
#15
Denise M Wilkes, Susan J Orillosa, Erik C Hustak, Courtney G Williams, Gulshan R Doulatram, Daneshvari R Solanki, Eduardo A Garcia, Li-Yen M Huang
Objectives: The goal of this study was to assess the success of the morphine microdose method in a community pain clinic setting by monitoring follow-up frequency, dose escalation, and monotherapy/polytherapy ratio. The morphine microdose method involves a pretrial reduction or elimination of systemic opioids followed by a period of abstinence. Intrathecal (IT) morphine is then started at doses of less than 0.2 mg per day. Systemic opioid abstinence is then continued after pump implant and IT morphine monotherapy...
June 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28964670/intrathecal-baclofen-treatment-an-option-in-x-linked-adrenoleukodystrophy
#16
Helgi Thor Hjartarson, Christoffer Ehrstedt, Kristina Tedroff
BACKGROUND: X-linked adrenoleukodystrophy (X-ALD) is a genetic peroxisomal disorder associated with tissue accumulation of very long chain fatty acids (VLCFAs). In approximately one third of affected males, this causes progressive and irreversible damage to the brain white matter. Progress is often rapid with upper motor neuron damage leading to severe spasticity and dystonia. The increased muscle tone is frequently difficult to alleviate with oral drugs. Here, we describe two patients with X-ALD who have received treatment with intrathecal baclofen pumps (ITB)...
January 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28913502/regional-anesthesia-for-a-total-knee-arthroplasty-on-an-adult-patient-with-spastic-diplegia-and-an-intrathecal-baclofen-pump
#17
Elird Bojaxhi, David R Salek, Courtney E Sherman, Roy A Greengrass
We describe the clinical presentation of a patient with spastic diplegia, and its unique perioperative challenges. Opioids and antispasmodic medications are the primary therapy for managing pain and spasticity in the perioperative setting. However, such combination results in several side-effects and their sedative properties are synergistic. A 64-year-old woman with a history of spastic diplegia and an intrathecal baclofen pump for the treatment of her lower extremity spasticity was scheduled for a third elective left knee arthroplasty...
April 2017: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28890435/pain-control-in-thoracic-oncology
#18
Christine Peeters-Asdourian, Gilbert Massard, Paragi H Rana, Paul Van Houtte, Andrew P White, Bogdan Grigoriu, Dominique Lossignol, Mohammed Almalki, Jean Alexiou, Jean-Luc Engelholm, Jean-Paul Sculier
This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28889721/spinal-myoclonus-responding-to-continuous-intrathecal-morphine-pump
#19
Jung-Eun Ahn, Dallah Yoo, Ki-Young Jung, Jong-Min Kim, Beomseok Jeon, Myung Chong Lee
Spinal myoclonus is a sudden, brief, and involuntary movement of segmental or propriospinal muscle groups. Spinal myoclonus has occasionally been reported in patients undergoing opioid therapy, but the pathophysiology of opioid-induced myoclonus has not been elucidated yet. Here, we present two patients with spinal segmental myoclonus secondary to ischemic and radiation myelopathy. Conventional medications did not help treat persistent myoclonus in both legs. Continuous intrathecal morphine infusion was implanted for pain control in one patient, which relieved spinal myoclonus entirely...
September 2017: Journal of Movement Disorders
https://www.readbyqxmd.com/read/28840489/plain-radiography-in-patients-treated-with-intrathecal-drug-delivery-using-an-implantable-pump-device
#20
Elmar M Delhaas, Biswadjiet S Harhangi, Sander P G Frankema, Frank J P M Huygen, Aad van der Lugt
OBJECTIVES: Intrathecal drug administration using an implanted pump system is well established in intractable spasticity and pain. However, despite continuous advancements in manufacturing technology, adverse events related to the pump and catheter still occur. Most of them, such as migration, damage, disconnection and occlusion, are related to the spinal catheter. The aim of this overview is to update radiologists on how plain radiography of the implanted delivery system for intrathecal drug administration should be interpreted and to increase awareness for the need of urgent and timely multidisciplinary troubleshooting...
October 2017: Insights Into Imaging
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