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Intrathecal Analgesic Drug Delivery is Effective for Analgesia in a Patient with Post-Poliomyelitis Syndrome: A Case Report.

Abstract
BACKGROUND Post-poliomyelitis syndrome (PPS) is a progressive neuromuscular syndrome, with chronic pain being one of the most prevalent symptoms. We present a case report on intrathecal analgesic drug delivery to diminish chro-nic, refractory pain in a patient with PPS. CASE REPORT In a wheelchair-bound 45-year-old female patient (Caucasian, body mass index [BMI] 20.5) with severe chronic, refractory pain, a Synchromed® II pump (Medtronic, Minneapolis, Minnesota, USA) was implanted after multidisciplinary consultation and a successful trial period. After 8 months, relocation of the pump due to regional pressure problems with surrounding erythema had to occur. A second pump relocation due to pressure pro-blems and skin erosion was needed 18 months after the first relocation, moving from the abdominal wall to the sheath of the rectus abdominis muscle, resulting in resolution of the problems. CONCLUSIONS In patients with PPS, intrathecal analgesic drug delivery can be an option to treat chronic, refractory pain. Multidisciplinary consultation is necessary to deal with the wide variety of problems in these patients. Skin problems at the site of the pump reservoir can be challenging and time-consuming and, ultimately, can necessitate relocation (or removal) of the device.
AuthorsCornelis W J van Tilburg
JournalThe American journal of case reports (Am J Case Rep) Vol. 17 Pg. 957-962 (Dec 16 2016) ISSN: 1941-5923 [Electronic] United States
PMID27980323 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Analgesics
Topics
  • Analgesics (administration & dosage)
  • Female
  • Humans
  • Injections, Spinal (methods)
  • Middle Aged
  • Pain (etiology)
  • Pain Management (methods)
  • Postpoliomyelitis Syndrome (complications, drug therapy)
  • Treatment Outcome

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