Intrathecal baclofen trial using a temporary indwelling intrathecal catheter - A single institution experience

J Clin Neurosci. 2019 Oct:68:33-38. doi: 10.1016/j.jocn.2019.07.073. Epub 2019 Aug 7.

Abstract

Intrathecal baclofen infusion trial is a sophisticated tool for selecting patients for permanent intra thecal baclofen infusion therapy We report our clinical experience of fifteen patients with refractory spasticity who underwent a continuous ITB trial using a temporary intraspinal indwelling catheter prior to permanent pump implantation. Patients underwent placement of a temporary intrathecal catheter that was connected to an external pump. Multisource feedback was obtained from the various healthcare professionals involved (Staff Nurse, Specialist nurse, physiotherapist, Doctor, family members, patient) regarding progress of test over 48-72 h. Average Modified Ashworth score after the trial was less than 2. Some degree of dose related minor adverse events (AEs) occurred in 8 patients, with the most common being nausea, constipation, urinary retention and hypotension. 10 patients received pump implant. 5 patients did not receive a pump because of AEs or because the goals were not met. 1 patient had pump removed after 4 years because of infection.

Keywords: Baclofen pump; Intrathecal baclofen; Intrathecal catheter.

MeSH terms

  • Aged
  • Baclofen / administration & dosage*
  • Baclofen / adverse effects
  • Catheters, Indwelling
  • Female
  • Humans
  • Infusion Pumps, Implantable
  • Injections, Spinal
  • Male
  • Middle Aged
  • Muscle Relaxants, Central / administration & dosage*
  • Muscle Relaxants, Central / adverse effects
  • Muscle Spasticity / drug therapy*
  • Patient Selection*
  • Retrospective Studies

Substances

  • Muscle Relaxants, Central
  • Baclofen