Catheter Obstruction of Intrathecal Drug Administration System -A Case Report-

Rhee, Seok Myeon; Choi, Eun Joo; Lee, Pyung Bok; Nahm, Francis Sahngun

doi:10.3344/kjp.2012.25.1.47

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…High concentrations (20 mg/ml), high daily doses (above 15 mg/day), and low flow rates for intrathecal morphine or hydromorphone infusions increase the risk of developing catheter-tip granulomas [12]. We expected that an IDDS in FMS would inhibit the central sensitization of pain [10], and would have fewer side effects than systemic opioid treatment [12]. In systemic review, the incidence of psychological dependence was low rate in who has no history of abuse behavior [13].…”

Section: Discussionmentioning

confidence: 99%

Implantable drug delivery systems with morphine in fibromyalgia -A case report-

Shin

Choi

et al. 2017

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.The fibromyalgia syndrome (FMS) could be approached by various treatments modalities including education, aerobic exercise, cognitive behavioral therapy, tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, pregabalin, and so on. If other treatments fail, opioids including morphine should be considered. In this case report, we describe the case of a 44-year-old woman who was diagnosed with FMS three years ago, and suffered from severe intractable pain, side effects from other drugs, and opioid tolerance. Administration of morphine via an implantable drug delivery system resulted in significant improvement in the patient's pain intensity, fibromyalgia impact questionnaire score, and sleep disturbance. Our case demonstrates that an implantable drug delivery system with morphine can be a potential treatment option for refractory fibromyalgia patients.

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Section: Discussionmentioning

confidence: 99%

Implantable drug delivery systems with morphine in fibromyalgia -A case report-

Shin

Choi

et al. 2017

Anesth Pain Med

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“…Any factor, or mechanical obstruction, that alter the drug spread within the CSF hampering to drug to get its site of action may be able to cause a clinical failure, side effects or complications [19-21]. …”

Section: Introductionmentioning

confidence: 99%

Role of Catheter's Position for Final Results in Intrathecal Drug Delivery. Analysis Based on CSF Dynamics and Specific Drugs Profiles

et al. 2013

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Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.

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“…Implantable intrathecal morphine pumps have been increasingly used in patients with intractable chronic pain [ 1 , 2 ]. Prior to making the decision to implant an ITMP, a trial administration of intrathecal morphine should be done to estimate the effective dose and to determine any untoward side effects from the morphine.…”

mentioning

confidence: 99%

Aspiration Pneumonitis Caused by Delayed Respiratory Depression Following Intrathecal Morphine Administration

et al. 2012

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Opioid analgesia is the primary pharmacologic intervention for managing pain. However, opioids can cause various adverse effects including pruritus, nausea, constipation, and sedation. Respiratory depression is the most fatal side effect. Therefore, cautious monitoring of respiratory status must be done after opioid administration. Here, we report a patient who suffered from respiratory depression with deep sedation and aspiration pneumonitis after intrathecal morphine administration.

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Catheter Obstruction of Intrathecal Drug Administration System -A Case Report-

Cited by 6 publications

References 13 publications

Implantable drug delivery systems with morphine in fibromyalgia -A case report-

Implantable drug delivery systems with morphine in fibromyalgia -A case report-

Role of Catheter's Position for Final Results in Intrathecal Drug Delivery. Analysis Based on CSF Dynamics and Specific Drugs Profiles

Aspiration Pneumonitis Caused by Delayed Respiratory Depression Following Intrathecal Morphine Administration

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