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Intrathecal Baclofen – The Importance of Catheter Position

Published online by Cambridge University Press:  18 September 2015

Herman Hugenholtz ,
Robert F. Nelson  and
Eric Dehoux
Herman Hugenholtz*
Affiliation:
Departments of Neurosurgery (H.H.), and Neurology (R.F.N.), Ottawa General Hospital; and Rehabilitation Medicine, Royal Ottawa Rehabilitation Centre, Ottawa
Robert F. Nelson
Affiliation:
Departments of Neurosurgery (H.H.), and Neurology (R.F.N.), Ottawa General Hospital; and Rehabilitation Medicine, Royal Ottawa Rehabilitation Centre, Ottawa
Eric Dehoux
Affiliation:
Departments of Neurosurgery (H.H.), and Neurology (R.F.N.), Ottawa General Hospital; and Rehabilitation Medicine, Royal Ottawa Rehabilitation Centre, Ottawa
*
Room 6353, Ottawa General Hospital, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6
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Abstract:

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In a patient receiving intrathecal baclofen injections for intractable trunk and leg spasms, positioning the subarachnoid catheter tip just caudal to the spinal segments innervating the spastic muscles enhanced the spasmolytic effect of bolus injections of intrathecal baclofen on the affected muscles. Such selective positioning of subarachnoid catheters may facilitate segmental spasmolysis with lower intrathecal doses of baclofen and provide an important alternative to relying only on ascending CSF concentration gradients of baclofen from chronic lumbar intrathecal infusion.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 20 , Issue 2 , May 1993 , pp. 165 - 167
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

References

1.Price, GW, Wilkin, GP, Tumbull, MJ, Bowery, NG. Are baclofen-sensitive GABA receptors present on primary afferent terminals of the spinal cord? Nature 1984; 307: 71–74.CrossRefGoogle ScholarPubMed
2.Penn, RD, Kroin, JS. Long-term intrathecal baclofen infusion for treatment of spasticity. J Neurosurg 1987; 66: 181–185.CrossRefGoogle ScholarPubMed
3.Yaksh, TL. Spinal opiate analgesia: characteristics and principles of action. Anaesthesiology 1981; 61: 293–346.Google Scholar
4.Dralle, D, Muller, H, Zeirski, J. Lumber intrathecal baclofen for cerebral palsy in children. The Physician India 1988; 4: 153–156.Google Scholar
5.Hugenholtz, H, Nelson, RF, Dehoux, E. Bickerton, R. Intrathecal baclofen for intractable spinal spasticity - a double-blind crossover comparison of 6 patients. Can J Neurosci 1992; 19: 188–195.Google Scholar
6.Loubser, PG, Narayan, RK, Sandin, KJ, Donovan, WH, Russell, KD. Continuous infusion of intrathecal baclofen: long-term effects on spasticity in spinal cord injury. Paraplegia 1991; 29: 48–64.Google ScholarPubMed
7.Muller, H, Zeirski, J. Long-term continuous intrathecal baclofen infusion. In: Marsden, CD, ed. Treating Spasticity: Pharmacological Advances. Toronto: Hans Huber 1989; 55–68.Google Scholar
8.Ochs, G, Struppler, A, Meyerson, BA, et al.Intrathecal baclofen for long-term treatment of spasticity: a multicentre study. J Neurol Neurosurg Psychiatry 1989; 52: 933–939.CrossRefGoogle Scholar
9.Penn, RD, Savoy, SN, Corcos, D, et al.Intrathecal baclofen for severe spinal spasticity. N Engl J Med 1989; 320: 1517–1521.CrossRefGoogle ScholarPubMed
10.Stewart-Wynne, EG, Hankey, GJ, Perlman, D. A place for intrathecal ‘Lioresal’ in spasticity. In: Jones, R. ed. Lioresal: An Update. North Rock: Neil Duncan 1988; 6–7.Google Scholar
11.Zierski, J. Muller, H, Dralle, D, Wurdinger, T. Implanted pump systems for treatment of spasticity. Acta Neurochir Suppl 1988; 43: 94–99.Google ScholarPubMed
12.Ochs, G. Intrathecal application of baclofen (Lioresal) in spasticity. In: Marsden, CD, ed. Treating Spasticity: Pharmacological Advances. Toronto: Hans Huber 1989; 49–54.Google Scholar
13.di, Chiro G. Observations on the circulation of the cerebrospinal fluid. Acta Radiologica 1966; 5: 988–1002.Google Scholar
14.Coombs, DW, Fratkin, JD, Meier, F, Nierenberg, DW, Saunders, RL. Neuropathologic lesions and CSF morphine concentrations during chronic continuous intraspinal morphine infusion. A clinical and post-mortem study. Pain 1985; 22: 337–351.Google ScholarPubMed
15.Muller-Schwefe, G, Penn, RD. Physostigmine in the treatment of intrathecal baclofen overdose. J Neurosurg 1989; 71: 273–275.CrossRefGoogle ScholarPubMed
16.Ventafridda, V, Figliuzzi, M, Tamburini, M, et al.Clinical observation on analgesia elicited by intrathecal morphine in cancer patients. In: Bonica, JJ, Liebeskind, JC, Albe-Fessard, DG. eds. Advances in Pain Research and Therapy. New York: Raven 1979; 559–565.Google Scholar
17.Jones, RF, Anthony, M, Torda, TA, Poulos, C. A place for epidural Lioresal in spasticity. In: Jones, RF, ed. Lioresal: An Update. North Rocks: Neil Duncan 1988; 8–11.Google Scholar
18.Cousins, MJ, Mather, LE. Intrathecal and epidural administration of opiates. Anaesthesiology 1984; 61: 276–310.Google Scholar