Intrathecal Baclofen Injection to Avoid Withdrawal in a Multiple Sclerosis Patient Undergoing Lumbar Spine Surgery: A Case Report
| Autor: | Robert P Devine, Sharon G Lynch, Sean R Jackson, Mirsad Dupanovic |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Lumbar spine surgery Spasticity Patient comfort Prolonged Surgery business.industry organic chemicals musculoskeletal neural and ocular physiology Multiple sclerosis 030208 emergency & critical care medicine General Medicine Perioperative medicine.disease Intrathecal baclofen Surgery body regions Baclofen nervous system chemistry Anesthesia medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | A&A Practice. 10:223-225 |
| ISSN: | 2575-3126 |
| DOI: | 10.1213/xaa.0000000000000668 |
| Popis: | Spasticity of spinal or cerebral origin is frequently treated with baclofen. Treatment interruption initially results in rebound spasticity; life-threatening withdrawal symptoms may follow. Severe rebound spasticity of leg muscles occurred in a multiple sclerosis patient after a 10-hour long perioperative pause of oral baclofen intake. In a subsequent spine surgery, recurrence was prevented by substituting a cumulative 12-hour oral baclofen dose with an intraoperative intrathecal injection. Administration of intrathecal baclofen during prolonged surgery in patients dependent on oral baclofen may improve patient comfort and prevent early withdrawal symptoms. The most optimal conversion ratio from oral to intrathecal baclofen is still undetermined. |
| Databáze: | OpenAIRE |
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