Intrathecal drug delivery systems complication

Background

Clinical Features

Differential Diagnosis

Complications:

Evaluation

Management

  • The device is not removed in an overdose but should be turned off.
  • Insertion of a 22-guage needle into the pump reservoir can remove all medication in case device cannot be turned off
  • Consider naloxone to reverse opioid effects taking into account patients chronicity of treatment if they withdrawal
  • Treat infection aggressively with antibiotics
    • May be treated without device removal with combination of IV and intrathecal antibiotics[1], but consult ID and/or anesthesia/appropriate surgical specialty as device may need to be removed

Disposition

See Also

External Links

References

  1. Aristedis R, Dimitrios P, Nikolaos P, Alexandros B. Intrathecal baclofen pump infection treated by adjunct intrareservoir teicoplanin instillation. Surg Neurol Int. 2017;8:38.