Simultaneous treatment of intractable pain and spasticity: observations of combined intrathecal baclofen-morphine therapy over a 10-year clinical experience

Autor:	M, Saulino
Rok vydání:	2011
Předmět:	Adult Male Baclofen Time Factors Adolescent Morphine Muscle Relaxants Central Middle Aged Pain Intractable Analgesics Opioid Young Adult Treatment Outcome Muscle Spasticity Humans Drug Therapy Combination Female Injections Spinal Aged Follow-Up Studies Pain Measurement Retrospective Studies
Zdroj:	European journal of physical and rehabilitation medicine. 48(1)
ISSN:	1973-9095
Popis:	Intrathecal therapy has separate indications for refractory pain and spasticity. Both entities have a relatively high prevalence in neurologic diseases. This study examines the potential efficacy of utilizing additive intrathecal morphine (ITM) therapy to a group of patients who had previously stabilized on intrathecal baclofen (ITB) therapy.Pain intensity was assessed via VASPI; 183 individuals participated in ITB therapy from January 1998 to December 2007. Forty-seven individuals elected to add ITM to their intrathecal therapy regimen. Three patients were intolerant to ITM/ITB combination therapy. No significant demographic differences between the two groups existed with respect to gender and race. Non-traumatic and traumatic spinal cord injury patients were more likely to participate in combination therapy compared to other diagnoses. The average stabilized ITB dose for the monotherapy group was not statistically different for the combination therapy group.The average stabilized ITM for the combination therapy group was 1 730 μg/day (range 27-10 500, SD 2 350). The average decrement in VASPI was 35%. Thirty out of 47 patients experienced a decrease greater than 30% in VASPI while 13 of the 47 patients experienced a decrease greater than 50% in Visual Analogue Scale of Pain Intensity (VASPI). There was no significant relationship between percent improvement in VASPI and morphine dosing. Eight of 47 combination patients experienced adverse events attributable to intrathecal morphine but were capable to utilize the combination therapy for a least one year.Reduction is pain intensity with combined therapy was variable. Intrathecal morphine can be a safe and effective adjunct pain therapy to patients utilizing intrathecal baclofen for spasticity.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::9ad091393b4e9f55518190eb00bf8c1e https://pubmed.ncbi.nlm.nih.gov/21525824 Zobrazit plný text záznamu