Document Detail


Correlation between withdrawal symptoms and medication pump residual volume in patients with implantable SynchroMed pumps.
MedLine Citation:
PMID:  15271246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jamal Taha; Jacques Favre; Michele Janszen; Marcelo Galarza; Assad Taha
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Neurosurgery     Volume:  55     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-23     Completed Date:  2004-09-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-3; discussion 393-4     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, Kettering Medical Center, Dayton, Ohio 45429, USA. jamal.taha@kmcnetwork.org
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MeSH Terms
Descriptor/Qualifier:
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:
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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