• Pain · May 2004

    Case Reports Comparative Study

    Spinal cord lesion after long-term intrathecal clonidine and bupivacaine treatment for the management of intractable pain.

    • Fabienne Perren, Eric Buchser, Dominique Chédel, Lorenz Hirt, Philippe Maeder, and François Vingerhoets.
    • CHUV, Neurology Department, 1011 Lausanne, Switzerland. fabienneperren@yahoo.com
    • Pain. 2004 May 1;109(1-2):189-94.

    AbstractLong-term intrathecal drug administration using implanted pumps is increasingly used in the treatment of chronic refractory pain [Anderson and Burchiel 1999, Neurosurgery 44 (1999) 289; Krames 2002, Best Pract Res Clin Anaesthesiol 16 (2002) 619; Wallace 2002, Neurology 59 (2002) S18]. Extensive clinical experience over the last 15 years suggests that in selected cases the technique is safe, although infections, system malfunction and drug-related complications have been reported. In most cases, drug-related spinal cord injuries have resulted from the compression of a spinal inflammatory mass or abcess rather than from a direct neurotoxic effect. We report on a case of toxic spinal cord lesion occurring after more than 3 years of uneventful continuous infusion of a mixture of bupivacaine and clonidine.

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