| Correlation between withdrawal symptoms and medication pump residual volume in patients with implantable SynchroMed pumps. | |
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MedLine Citation:
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PMID: 15271246 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate whether patients with implantable SynchroMed pumps (Medtronic, Inc., Minneapolis, MN) develop symptoms of drug withdrawal at residual medication volumes that exceed 2 ml (the alarm residual volume recommended by the manufacturer). METHODS: The data sheets of 88 patients with implantable SynchroMed pumps were retrospectively reviewed. The following parameters were analyzed: development of symptoms of drug withdrawal; drugs used in the pump; disease state; drug residual volume in the pump; intake of orally administered medications; time of development of withdrawal symptoms; drug flow volume through the pump; daily intrathecally administered drug dose; and drug concentration in the pump. RESULTS: Of 88 patients, 21 (24%) consistently developed symptoms of drug withdrawal 1 to 7 days before the drug residual volume reached a mean of 2.7 ml (range, 2.1-3.8 ml; median, 2.6 ml). Symptoms first developed 1 to 18 months after surgery. In all patients, symptoms of drug withdrawal subsided after pump refill and did not recur after the alarm volume was increased to 4 ml. Symptom development did not correlate with intake of orally administered medication, drug flow volume through the pump, intrathecally administered drug dose, drug concentration in the pump, drugs used in the pump, or disease state. CONCLUSION: Some patients develop symptoms of drug withdrawal at residual volumes that exceed 2 ml. We could not identify factors that predict this occurrence. Withdrawal symptoms did not recur when the alarm volume was increased to 4 ml. |
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Authors:
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Jamal Taha; Jacques Favre; Michele Janszen; Marcelo Galarza; Assad Taha |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study |
Journal Detail:
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Title: Neurosurgery Volume: 55 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-07-23 Completed Date: 2004-09-16 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 390-3; discussion 393-4 Citation Subset: IM |
Affiliation:
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Division of Neurosurgery, Kettering Medical Center, Dayton, Ohio 45429, USA. jamal.taha@kmcnetwork.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Analgesia, Epidural / instrumentation* Analgesics, Opioid / administration & dosage, adverse effects* Baclofen / administration & dosage, adverse effects Bupivacaine / administration & dosage, adverse effects Clonidine / administration & dosage, adverse effects Dose-Response Relationship, Drug Drug Administration Schedule Drug Therapy, Combination Equipment Design Equipment Failure Female Fentanyl / administration & dosage, adverse effects Humans Hydromorphone / administration & dosage, adverse effects Infusion Pumps, Implantable* Male Middle Aged Morphine / administration & dosage, adverse effects Muscle Spasticity / drug therapy* Neurologic Examination / drug effects Pain, Intractable / drug therapy* Quality of Life Retrospective Studies Substance Withdrawal Syndrome / diagnosis* |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 1134-47-0/Baclofen; 2180-92-9/Bupivacaine; 4205-90-7/Clonidine; 437-38-7/Fentanyl; 466-99-9/Hydromorphone; 57-27-2/Morphine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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