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1.
Anesthesia and Pain Medicine ; : 211-215, 2019.
Article Dans Anglais | WPRIM | ID: wpr-762248

Résumé

A 55-year-old man with an implantable intrathecal drug delivery system (IDDS) implant removal surgery was performed to control a suspected implant infection. Clear discharge from a lumbar wound was detected after IDDS removal, but transcutaneous cerebral spinal fluid (CSF) leakage was not suspected because the patient did not suffer from a postural headache. Finally, a suspected CSF leakage was resolved with a single epidural blood patch.


Sujets)
Humains , Adulte d'âge moyen , Colmatage sanguin épidural , Systèmes de délivrance de médicaments , Céphalée , Algie post-zona , Plaies et blessures
2.
Cancer Research and Clinic ; (6): 210-213, 2015.
Article Dans Chinois | WPRIM | ID: wpr-473086

Résumé

Since cancer-related pain is the worldwide problem,intrathecal drug delivery system (IDD)has been an effective pain management option for patients with chronic and cancer pain.Compared with the other ways,such as oral or intravenous infusion,the delivery of drugs into the intrathecal space provides superior analgesia with lower doses of analgesics to minimize side effects while significantly improve quality of life.Recently,besides traditional opioid (especially mainly morphine) for intrathecal,clinical experts have also found some other drugs could be used for IDD to control the cancer-related pain,and have observed their effect and related adverses.This article aims to provide a general overview of the development trend in this field.

3.
Anest. analg. reanim ; 26(2): 2-2, dic. 2013. ilus, tab
Article Dans Espagnol | LILACS | ID: lil-754088

Résumé

Se comunica el caso de un paciente portador de dolor lumbar crónico post-cirugía de columna, al que se le implantó un sistema para infusión de morfina intratecal. Los resultados mostraron una disminución de las dosis de morfina sistémica y un satisfactorio control del dolor que disminuyó un 50% al año y un 75% a los 6 años. La interferencia del dolor sobre la capacidad de caminar disminuyó un 25% al año y un 50% a los 6 años, mientras que su repercusión sobre la calidad de vida disminuyó un 37.5% al año y un 62.5% a los 6 años, no habiendo requerido internaciones por dolor durante el período analizado. Si bien el requerimiento de morfina intratecal aumentó a lo largo de los 6 años, las dosis utilizadas fueron bajas, siendo 1.16 mg/d la dosis máxima alcanzada...


Sujets)
Humains , Mâle , Adulte d'âge moyen , Pompes à perfusion implantables/effets indésirables , Pompes à perfusion implantables , Douleur chronique/thérapie , Morphine/administration et posologie , Morphine/usage thérapeutique , Injections rachidiennes , Qualité de vie
4.
The Korean Journal of Pain ; : 336-346, 2013.
Article Dans Anglais | WPRIM | ID: wpr-155344

Résumé

Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.


Sujets)
Humains , Analgésiques morphiniques , Anesthésiques locaux , Baclofène , Cathéters , Douleur chronique , Posture
5.
Journal of Korean Medical Science ; : 1371-1377, 2011.
Article Dans Anglais | WPRIM | ID: wpr-127686

Résumé

Glycine and gamma-aminobutyric acid (GABA) are localized and released by the same interneurons in the spinal cord. Although the effects of glycine and GABA on analgesia are well known, little is known about the effect of GABA in strychnine-induced hyperalgesia. To investigate the effect of GABA and the role of the glycine receptor in thermal hyperalgesia, we designed an experiment involving the injection of muscimol (a GABAA receptor agonist), baclofen (a GABAB receptor agonist) or glycine with strychnine (strychnine sensitive glycine receptor antagonist). Glycine, muscimol, or baclofen with strychnine was injected into the cisterna magna or lumbar subarachnoidal spaces of mice. The effects of treatment on strychnine-induced heat hyperalgesia were observed using the pain threshold index via the hot plate test. The dosages of experimental drugs and strychnine we chose had no effects on motor behavior in conscious mice. Intracisternal or intrathecal administration of strychnine produced thermal hyperalgesia in mice. Glycine antagonize the effects of strychnine, whereas, muscimol or baclofen does not. Our results indicate that glycine has anti-thermal hyperalgesic properties in vivo; and GABA receptor agonists may lack the binding abilities of glycine receptor antagonists with their sites in the central nervous system.


Sujets)
Animaux , Mâle , Souris , Baclofène/administration et posologie , Systèmes de délivrance de médicaments , Agonistes GABA/administration et posologie , Antagonistes GABA/administration et posologie , Glycine/administration et posologie , Température élevée , Hyperalgésie/induit chimiquement , Injections rachidiennes , Souris de lignée ICR , Muscimol/administration et posologie , Seuil nociceptif , Répartition aléatoire , Strychnine , Acide gamma-amino-butyrique/métabolisme
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