Prevention of intrathecal baclofen withdrawal syndrome: successful use of a temporary intrathecal catheter

Anke Bellinger; Rapipen Siriwetchadarak; Richard Rosenquist; Jeremy D W Greenlee

doi:10.1097/AAP.0b013e3181b4cc6b

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Prevention of intrathecal baclofen withdrawal syndrome: successful use of a temporary intrathecal catheter

Journal article

Peer reviewed

Prevention of intrathecal baclofen withdrawal syndrome: successful use of a temporary intrathecal catheter

Anke Bellinger, Rapipen Siriwetchadarak, Richard Rosenquist and Jeremy D W Greenlee

Regional anesthesia and pain medicine, Vol.34(6), pp.600-602

11/2009

DOI: 10.1097/AAP.0b013e3181b4cc6b

PMID: 19920430

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Abstract

Abrupt cessation of intrathecal baclofen (ITB) administration can cause a life-threatening withdrawal syndrome that requires prompt diagnosis and urgent treatment. The current therapy for this condition is administration of propofol, benzodiazepines, paralytics and supportive care. This study reports a 53-year-old patient with paraplegia with an ITB infusion who presented with an infected pump site. The pump and the catheter were surgically removed and replaced with a temporary externalized intrathecal catheter. The ITB infusion was tapered and simultaneously substituted with progressively higher doses of oral antispasmotics. With this strategy, we were able to avoid life-threatening complications.

Device Removal

Muscle Relaxants, Central - administration & dosage

Spinal Cord Injuries - drug therapy

Substance Withdrawal Syndrome - etiology

Spinal Cord Injuries - complications

Substance Withdrawal Syndrome - prevention & control

Humans

Middle Aged

Male

Baclofen - adverse effects

Anti-Bacterial Agents - therapeutic use

Catheters, Indwelling - adverse effects

Infusion Pumps, Implantable

Drug Administration Schedule

Administration, Oral

Baclofen - administration & dosage

Infusions, Parenteral

Treatment Outcome

Accidents, Traffic

Paraplegia - etiology

Clonidine - analogs & derivatives

Paraplegia - drug therapy

Catheter-Related Infections - microbiology

Muscle Relaxants, Central - adverse effects

Clonidine - administration & dosage

Details

Title: Subtitle: Prevention of intrathecal baclofen withdrawal syndrome: successful use of a temporary intrathecal catheter
Creators: Anke Bellinger - Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, IA 62242, USA. Anke-Bellinger@uiowa.edu
Rapipen Siriwetchadarak
Richard Rosenquist
Jeremy D W Greenlee
Resource Type: Journal article
Publication Details: Regional anesthesia and pain medicine, Vol.34(6), pp.600-602
Publisher: England
DOI: 10.1097/AAP.0b013e3181b4cc6b
PMID: 19920430
ISSN: 1098-7339
eISSN: 1532-8651
Language: English
Date published: 11/2009
Academic Unit: Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984040386402771

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