Catheter Obstruction of Intrathecal Drug Administration System -A Case Report-
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Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.
Abstract
Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.
참고문헌 (12)
- 남상건, "척수강 내 약물 주입술", The Korean Journal of Pain, 22(2), pp.117~123 (2009), 대한통증학회
- Onofrio BM, "Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin", Mayo Clin Proc, 56, pp.516~520 (1981)
- Johnston J, "Shiley INFUSAID Pump technology", Ann N Y Acad Sci, 531, pp.57~65 (1988)
- Belverud S, "Intrathecal pumps", Neurotherapeutics, 5, pp.114~122 (2008)
- Paice JA, "Intraspinal morphine for chronic pain: a retrospective, multicenter study", J Pain Symptom Manage, 11, pp.71~80 (1996)
- Deer T, "Management of intrathecal catheter-tip inflammatory masses: an updated 2007 consensus statement from an expert panel", Neuromodulation, 11, pp.77~91 (2008)
- North RB, "Spinal cord compression complicating subarachnoid infusion of morphine: case report and laboratory experience", Neurosurgery, 29, pp.778~784 (1991)
- Yaksh TL, "Inflammatory masses associated with intrathecal drug infusion: a review of preclinical evidence and human data", Pain Med, 3, pp.300~312 (2002)
- Magazine HI, "Morphine-induced conformational changes in human monocytes, granulocytes, and endothelial cells and in invertebrate immunocytes and microglia are mediated by nitric oxide", J Immunol, 156, pp.4845~4850 (1996)
- Miele VJ, "A review of intrathecal morphine therapy related granulomas", Eur J Pain, 10, pp.251~261 (2006)
- Hassenbusch S, "Management of intrathecal catheter-tip inflammatory masses: a consensus statement", Pain Med, 3, pp.313~323 (2002)
- Coffey RJ, "Inflammatory mass lesions associated with intrathecal drug infusion catheters: report and observations on 41 patients", Neurosurgery, 50, pp.78~86 (2002)