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Baclofen bridging, weaning protocol and pain management of a person with T6 paraplegia who required removal of intrathecal baclofen pump due to wound infection
  1. Jessica Roth1,
  2. Hayder Agha1,2 and
  3. Charlotte Davis1,2
  1. 1London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
  2. 2SCIC, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
  1. Correspondence to Charlotte Davis; charlotte.davis25{at}nhs.net

Abstract

Intrathecal baclofen is recognised as an effective treatment option for severe symptoms of segmental spasticity after spinal cord injury. We present our experience of a case of a patient who was admitted to our centre for elective intrathecal baclofen pump revision surgery, but postsurgical complications of a blocked catheter and subsequent wound infections meant the pump had to be removed. In this case, treatment of severe spasticity and nociceptive pain was required while avoiding potentially lethal side effects of sudden baclofen withdrawal. We suggest an effective bridging and weaning protocol for oral drug titration to treat spasticity and pain as a blended syndrome in this challenging situation.

  • rehabilitation medicine
  • spinal cord

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Footnotes

  • Contributors JR: drafted and prepared the manuscipt and liaised with patient. HA: Consultant of patient and helped with revision of manuscript. CD: helped with manuscript preparation and collecting initial research from patient/previous medical notes.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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