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Información de la revista
Vol. 40. Núm. 2.
Páginas 158-161 (Mayo - Julio 2012)
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Vol. 40. Núm. 2.
Páginas 158-161 (Mayo - Julio 2012)
DOI: 10.1016/S2256-2087(12)70033-0
Acceso a texto completo
Management Baclofen Withdrawal Syndrome
Manejo del síndrome de abstinencia por interrupción del baclofeno
Visitas
...
Lisgelia Santanaa, Manuel Quinterob,
Autor para correspondencia
manuequinteromd@yahoo.com

Corresponding author: Departamento de Anestesiología, Facultad de Medicina, Universidad de Puerto Rico, P.O. Box 365067, 00936-5067 San Juan, Puerto Rico.
a Instructor, Interventional Pain Clinic, University of Puerto Rico, San Juan, Puerto Rico
b MD, Interventional Pain Fellowship, Department of Anesthesiology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico
Información del artículo
Abstract

Intrathecal baclofen therapy is a treatment that can relieve some symptoms of severe spasticity. Currently intrathecal baclofen infusion is used primarily for spasticity associated with cerebral palsy, brain or spinal injury, traumatic brain injury, anoxic encephalopathy, multiple sclerosis, dystonia, stroke and stiff-man syndrome, particularly for those patients who are unresponsive. Patients can present central nervous system side effects, this can occur as a result of the pump delivering an incorrect dose of baclofen. Sudden cessation of Intrathecal baclofen administration can cause mild to severe symptoms. We report a case of Intrathecal baclofen withdrawal syndrome developing severe spasticity and its management.

Keywords:
Baclofen
Substance withdrawal syndrome
Spinal injections
Muscle spasticity
Resumen

La terapia con baclofeno intratecal es un tratamiento que puede aliviar algunos de los síntomas de la espasticidad severa. Actualmente, la infusión de baclofeno intratecal se utiliza principalmente para el manejo de la espasticidad asociada con parálisis cerebral, lesiones cerebrales o de columna vertebral, traumatismo craneoencefálico, encefalopatía anóxica, esclerosis múltiple, distonía, secuelas de accidente cerebrovascular y síndrome del hombre rígido, especialmente para los pacientes que no responden a otros tratamientos. Los pacientes pueden sufrir efectos secundarios en sistema nervioso central con este manejo, como consecuencia de un error de dosificación del baclofeno en la bomba. El cese repentino de la administración del baclofeno intratecal puede causar síntomas, que van desde leves hasta graves. Presentamos un caso de síndrome de abstinencia por baclofeno intratecal y su manejo exitoso en un paciente en que se desarrolló espasticidad severa.

Palabras clave:
Baclofeno
Síndrome de abstinencia de sustancias
Inyecciones espinales
Espasticidad muscular
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References
[1.]
R.J. Coffey, T.S. Edgar, G.E. Francisco, V. Graziani, J.M. Meythaler, P.M. Ridgely, et al.
Abrupt withdrawal from intrathecal baclofeno: recognition and management of a potentially lifethreatening syndrome.
Arch Phys Med Rehabil, 83 (2002), pp. 735-741
[2.]
K. Kolaski, L.R. Logan.
A review of the complications of intrathecal baclofen in patients with cerebral palsy.
Neuro Rehabil, 22 (2007), pp. 383-395
[3.]
P.M. Brennan, I.R. Whittle.
Intrathecal baclofeno therapy for neurological disorders: a sound knowledge base but many challenges remain.
Br J Neurosurg, 22 (2008), pp. 508-519
[4.]
D. Dykstra, M. Stuckey, L. DesLauriers, D. Chappuis, L. Krach.
Intrathecal baclofeno in the treatment of spasticity.
Acta Neurochir Suppl, 97 (2007), pp. 163-171
[5.]
L. Stempien, T. Tsai.
Intrathecal baclofeno pump use for spasticity: a clinical survey.
Am J Phys Med Rehabil, 79 (2000), pp. 536-541
[6.]
R. Gilmartin, D. Bruce, B.B. Storrs, R. Abbott, L. Krach, J. Ward, et al.
Intrathecal baclofeno for management of spastic cerebral palsy: multicenter trial.
J Child Neurol, 15 (2000), pp. 71-77
[7.]
R.J. Coffey, T.S. Edgar, G.E. Franciso, et al.
Abrupt withdrawal from intrathecal baclofeno: recognition and management of a potentially life-threatening syndrome.
Arch Phys Med Rehabil, 83 (2002), pp. 735-740
[8.]
L.W. Kao, Y. Amin, M.A. Kirk, et al.
Intrathecal baclofeno withdrawal mimicking sepsis.
J Emerg Med, 24 (2003), pp. 423-427
[9.]
R.J. Coffey, T.S. Edgar, G.E. Francisco, et al.
Abrupt withdrawal from intrathecal baclofeno: recognition and management of potentially lifethreatening syndrome.
Arch Phys Med Rehabil, 83 (2002), pp. 735-741
[10.]
U.S. Food and Drug Administration. MedWatch. The FDA Safety Information and Adverse Event Reporting Program. Lioresal Intrathecal (baclofeno injection) [cited April 2002]. Available from: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm154505.htm.
[11.]
B.S. Duhon, J.D. MacDonald.
Infusion of intrathecal baclofeno for acute withdrawal.
J Neurosurg, 107 (2007), pp. 878-880
[12.]
G.L. Ackland, R. Fox.
Low-dose propofol infusion for controlling acute hyperspasticity after withdrawal of intrathecal baclofeno therapy.
Anesthesiology, 103 (2005), pp. 663-665
[13.]
A. Khorasani, W.T. Peruzzi.
Dantroleno treatment for abrupt intrathecal baclofeno withdrawal.
Anesth Analg, 80 (1995), pp. 1054-1056
[14.]
L. Schwieler, D.S. Delbro, G. Engberg, S. Ernardt.
The anesthetic agent propofol interacts with GABA(B)-receptors: an electrophysiological study in rat.
Life Sci, 72 (2003), pp. 2793-2801
[15.]
R. Nadeson, C.S. Goodchild.
Antinociceptive properties of propofol: involvement of spinal cord F-aminobutyric acidA receptors.
J Pharmacol Exp Ther, 282 (1997), pp. 1181-1186
[16.]
A. Bellinger, R. Siriwetchadarak, R. Rosenquist, J. Greenlee.
Prevention of intrathecal baclofeno withdrawal syndrome successful use of a temporary intrathecal catheter.
Reg Anesth Pain Med, 34 (2009), pp. 600-602
[17.]
J.C. Ross, A.M. Cook, G.L. Stewart, B.G. Fahy.
Acute intrathecal baclofeno withdrawal: a brief review of treatment options.
Neurocritical Care, 14 (2011), pp. 103-108
Copyright © 2012. Sociedad Colombiana de Anestesiología y Reanimación
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