Abstract
Intraspinal (intrathecal) infusion using fully implantable pump and catheter systems is a possibility of therapy for selected patients with severe chronic pain and spasticity. Adverse events are an unavoidable part of long-term intrathecal delivery drug systems.There are described adverse side effects and complications, their origins, detection, manifestation and their management-prevention in this article.
There are three main categories of potential adverse events and complications associated with intrathecal drug delivery systems: pharmacological side effects, surgical complications, and device-related complications. Most of the adverse events and complications are minor, but some may be severe and lethal.
The serious complications often require surgical intervention or enough discontinuation of therapy and removal of system.We tested 23 patients with intrathecal bolus of morphine and 16 patients with bolus of baclofen and found 11 complications and side effects. We found 7 complications in our group of 20 implanted drug delivery systems (12 for the treatment of FBSS, 8 for spasticity in MS).
The most important complication was severe infection, which leads to removal of the whole system