Prevention of Intrathecal Drug Delivery Catheter‐Related Complications

In an effort to improve the performance of implantable intrathecal drug delivery systems, a group of physicians experienced in the management of such devices reviewed surgical practices and principles that were associated with low catheter‐related complication rates. Clinical study and postmarket data identified physicians whose patients experienced a relatively low rate of catheter‐related complications. Six of those physicians (three anesthesiologists and three neurosurgeons) reviewed the number and types of intrathecal drug pumps and catheters they had implanted, with an emphasis on the specific details of successful catheter implantation techniques. The authors pooled their experiences to reach a consensus on implant techniques that are associated with a low rate of postoperative complications.

[1]  J. Drake,et al.  Cerebrospinal fluid shunt infection: a prospective study of risk factors. , 2001, Journal of neurosurgery.

[2]  K. Follett,et al.  A prospective study of catheter-related complications of intrathecal drug delivery systems. , 2000, Journal of pain and symptom management.

[3]  E. Krames,et al.  Reliability and Clinical Utility of an Implanted Intraspinal Catheter Used in the Treatment of Spasticity and Pain , 2000, Neuromodulation : journal of the International Neuromodulation Society.

[4]  A. Koulousakis,et al.  Drug Adverse Events and System Complications of Intrathecal Opioid Delivery for Pain: Origins, Detection, Manifestations, and Management , 1999, Neuromodulation : journal of the International Neuromodulation Society.

[5]  J. Drake,et al.  Efficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts: meta-analysis. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[6]  James M. Drake,et al.  A concerted effort to prevent shunt infection , 1993, Child's Nervous System.

[7]  R. Penn,et al.  Intrathecal baclofen for intractable spasticity of spinal origin: results of a long-term multicenter study. , 1993, Journal of neurosurgery.

[8]  D. Coombs,et al.  CONTINUOUS EPIDURAL ANALGESIA VIA IMPLANTED MORPHINE RESERVOIR , 1981, The Lancet.

[9]  T. Yaksh,et al.  Continuous low-dose intrathecal morphine administration in the treatment of chronic pain of malignant origin. , 1981, Mayo Clinic proceedings.

[10]  Current trends in antibiotic prophylaxis in surgery. , 2000, Surgery.

[11]  B. Walters,et al.  Antibiotic prophylaxis for cerebrospinal fluid shunts: a metanalysis. , 1994, Neurosurgery.

[12]  B. Walters,et al.  Antibiotic Prophylaxis for Cerebrospinal Fluid Shunts , 1994 .