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Use of intrathecal baclofen administered by programmable infusion pumps in resistent spasticity.

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Autores
Broseta, J.
Morales, F.
Garcia, G.
Sanchez Ledesma, M. J.
Anaja, J.
Gonzalez Darder, J.
Barberá, J.

Fecha
1989

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Editor
Springer Nature

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Resumen
Abstract
On the basis of previous experimental and clinical studies1,2 patients with severe spasticity due to spinal cord damage from multiple sclerosis in 8 cases and postraumatic paraplegia in 6 and resistent to all conservative treatments were selected for a trial with morphine and baclofen administered intrathecally through a catheter placed in the spinal subarachnoid space rostral to the affected segments and attached to a subcutaneous reservoir. Whereas morphine single injection did not show any benefit, baclofen bolus injection 30 to 60 ?g, revealed a marked decrease of spasticity and associated symptoms in 8 cases. After checking the clinical effect during 3 weeks and changes in electroneurophysiological studies and bladder manometry the catheter was attached to a subcutaneous programmable pump able to be refilled percutaneously and administered baclofen continuously or more often following a multistep complex programme in total doses of 90 to 150 ?g per day. After a mean follow-up of 5 months all cases showed an absence of spasms and pain, a notable improvement for bettering of sphincter functions and a marked muscle relaxation that improves motor capacity, leading to increased ambulation or mobility. Neither complications nor side-effects were observed.
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Keywords
Spasticity , Intrathecal , Baclofen , Infusion pump
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