Intrathecal pumps are relatively new devices that deliver potent medications directly into the cerebrospinal fluid and are implanted for chronic conditions, including severe malignant and non-malignant pain as well as spasticity. ICU providers may encounter them in the course of their practice, so it is important to be familiar with their function and how they may affect patient management. This article briefly highlights some of common complications and considerations that would be applicable in an ICU setting.
FlückigerBKnechtHGrossmannSFelleiterP. Device-related complications of long-term intrathecal drug therapy via implanted pumps. Spinal Cord. 2008;46:639-643.
PlassatRPerrouin VerbeBMeneiPMenegalliDMathéJFRichardI. Treatment of spasticity with intrathecal Baclofen administration: long-term follow-up, review of 40 patients. Spinal Cord. 2004;42:686-693.
8.
HansenCRGoochJLSuch-NeiberT. Prolonged, severe intrathecal baclofen withdrawal syndrome: a case report. Arch Phys Med Rehabil. 2007;88:1468-1471.
9.
MohammedJHussainA. Intrathecal baclofen withdrawal syndrome—a life-threatening complication of baclofen pump: a case report. BMC Clin Pharmacol. 2004;4:6.
10.
RocheNSchnitzlerAGenêtFBen SmailD. Radiculopathy following intrathecal baclofen pump implantation [in French]. Ann Readapt Med Phys. 2006;49:248-251.
11.
De AndresJVillanuevaVPalmisaniS. The safety of magnetic resonance imaging in patients with programmable implanted intrathecal drug delivery systems: a 3-year prospective study. Anesth Analg. 2011;112:1124-1129.
12.
DiehnFEWoodCPWatsonREJrMauckWDBurkeMMHuntCH. Clinical safety of magnetic resonance imaging in patients with implanted SynchroMed EL infusion pumps. Neuroradiology. 2011;53:117-122.