Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre

Detalhes bibliográficos
Autor(a) principal: Reis, Pedro Videira
Data de Publicação: 2019
Outros Autores: Vieira, Catarina Rocha, Midões, Ana Cristina, Rebelo, Virginia, Barbosa, Paula, Gomes, Armanda
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482
Resumo: Introduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn’s scales, Katz index and patients’ global satisfaction were analysed.Results: In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 – 89) and the total follow-up time was 96 (9 – 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn’s scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.Discussion: The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.Conclusion: Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life.
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spelling Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese CentreBombas Perfusoras de Baclofeno Intratecal no Tratamento da Espasticidade: Estudo de Coorte Retrospetivo num Centro PortuguêsBaclofen/administration & dosageBaclofen/therapeutic useInfusion PumpsImplantableMuscle Spasticity/drug therapyBaclofeno/administração e dosagemBaclofen/uso terapêuticoBombas de Infusão ImplantáveisEspasticidade Muscular/tratamentoIntroduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn’s scales, Katz index and patients’ global satisfaction were analysed.Results: In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 – 89) and the total follow-up time was 96 (9 – 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn’s scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.Discussion: The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.Conclusion: Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life.Introdução: A espasticidade é um problema complexo em doentes com distúrbios neurológicos influenciando a sua qualidade de vida. As bombas perfusoras intratecais de baclofeno reduzem a espasticidade com doses baixas e efeitos laterais mínimos, mas não estão livres de complicações. Pretendemos avaliar a eficácia, segurança e satisfação dos doentes com bombas perfusoras intratecais de baclofeno.Material e Métodos: Estudo de coorte retrospetivo, incluindo todas as bombas perfusoras intratecais de baclofeno colocadas até dezembro de 2015. Foram avaliadas as características demográficas, diagnósticos, data de colocação ou retirada/substituição e complicações das bombas perfusoras intratecais de baclofeno. Analisaram-se as escalas Ashworth, Penn, Katz e satisfação dos doentes.Resultados: Durante 19 anos colocaram-se 251 bombas perfusoras intratecais de baclofeno em 155 doentes. A idade média foi 41,1 ± 15,8 anos. As patologias mais freqüentes foram: traumatismo (34%), paralisia cerebral (14%), esclerose múltipla (12%) e acidente vascular cerebral (12%). Oitenta e cinco doentes (55%) precisaram de uma segunda e onze (7%) de uma terceira bomba. A semi-vida da primeira bomba foi 72 (36 – 89) e o tempo total de seguimento 96 (9 – 132) meses. As causas de retirada/substituição foram: falha de bateria (57%), migração/kinking do cateter (24%), infeção (14%) e deslocamento/exteriorização da bomba (7%). A taxa de complicações foi 0,21 eventos/mês. Houve uma melhoria significativa nas escalas de Ashworth e Penn após colocação das bombas perfusoras intratecais de baclofeno (p < 0,001 para todos os diagnósticos) e os doentes ficaram satisfeitos com o tratamento.Discussão: A incidência de complicações situou-se dentro do intervalo reportado por outros estudos internacionais, apesar do longo tempo de seguimento. Número de eventos por mês, perda de seguimento, taxas de re-intervenção ou infecção e mortalidade foram semelhantes a outros estudos.Conclusão: As bombas perfusoras intratecais de baclofeno são seguras e eficazes no tratamento da espasticidade e oferecem um alto nível de satisfação quanto ao tratamento e qualidade de vida.Ordem dos Médicos2019-12-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/tiffimage/tiffimage/tiffimage/tiffapplication/pdfapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482oai:ojs.www.actamedicaportuguesa.com:article/10482Acta Médica Portuguesa; Vol. 32 No. 12 (2019): December; 754-759Acta Médica Portuguesa; Vol. 32 N.º 12 (2019): Dezembro; 754-7591646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/5809https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10124https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10125https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10126https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/10127https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11007https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11209https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10482/11523Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessReis, Pedro VideiraVieira, Catarina RochaMidões, Ana CristinaRebelo, VirginiaBarbosa, PaulaGomes, Armanda2022-12-20T11:05:59Zoai:ojs.www.actamedicaportuguesa.com:article/10482Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:53.605932Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
Bombas Perfusoras de Baclofeno Intratecal no Tratamento da Espasticidade: Estudo de Coorte Retrospetivo num Centro Português
title Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
spellingShingle Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
Reis, Pedro Videira
Baclofen/administration & dosage
Baclofen/therapeutic use
Infusion Pumps
Implantable
Muscle Spasticity/drug therapy
Baclofeno/administração e dosagem
Baclofen/uso terapêutico
Bombas de Infusão Implantáveis
Espasticidade Muscular/tratamento
title_short Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
title_full Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
title_fullStr Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
title_full_unstemmed Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
title_sort Intrathecal Baclofen Infusion Pumps in the Treatment of Spasticity: A Retrospective Cohort Study in a Portuguese Centre
author Reis, Pedro Videira
author_facet Reis, Pedro Videira
Vieira, Catarina Rocha
Midões, Ana Cristina
Rebelo, Virginia
Barbosa, Paula
Gomes, Armanda
author_role author
author2 Vieira, Catarina Rocha
Midões, Ana Cristina
Rebelo, Virginia
Barbosa, Paula
Gomes, Armanda
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Reis, Pedro Videira
Vieira, Catarina Rocha
Midões, Ana Cristina
Rebelo, Virginia
Barbosa, Paula
Gomes, Armanda
dc.subject.por.fl_str_mv Baclofen/administration & dosage
Baclofen/therapeutic use
Infusion Pumps
Implantable
Muscle Spasticity/drug therapy
Baclofeno/administração e dosagem
Baclofen/uso terapêutico
Bombas de Infusão Implantáveis
Espasticidade Muscular/tratamento
topic Baclofen/administration & dosage
Baclofen/therapeutic use
Infusion Pumps
Implantable
Muscle Spasticity/drug therapy
Baclofeno/administração e dosagem
Baclofen/uso terapêutico
Bombas de Infusão Implantáveis
Espasticidade Muscular/tratamento
description Introduction: Spasticity is a complex problem in patients with neurological disorders and may distress their quality of life. Intrathecal baclofen infusion pumps reduce spasticity with low doses and minimal side effects but are not free from complications. We aimed to evaluate the efficacy and safety of intrathecal baclofen infusion pumps as well as patients’ satisfaction.Material and Methods: Retrospective cohort study including all intrathecal baclofen infusion pumps placed up to December 2015. Demographic characteristics, clinical diagnoses, date of placement or withdrawal/replacement of intrathecal baclofen infusion pumps, baclofen dosage and complications of intrathecal baclofen infusion pumps were collected. Assessments from the Ashworth and Penn’s scales, Katz index and patients’ global satisfaction were analysed.Results: In 19 years we placed 251 intrathecal baclofen infusion pumps in 155 patients. The mean age was 41.1 ± 15.8 years. The most frequent conditions were: trauma (34%), cerebral palsy (14%), multiple sclerosis (12%) and stroke (12%). Eighty-five patients (55%) required a second pump, and eleven (7%) a third one. The lifetime of the first pump was 72 (36 – 89) and the total follow-up time was 96 (9 – 132) months. The causes of withdrawal/replacement were: battery failure (57%), catheter migration/kinking (24%), infection (14%) and pump displacement/exteriorization (7%). The complication rate was 0.21 events/month. There was a significant improvement in the Ashworth and Penn’s scales after the placemen of intrathecal baclofen infusion pumps (p < 0.001 for all diagnoses) and the patients were satisfied with the treatment.Discussion: The incidence of complications was within range of other international studies despite our long follow-up time. Events per month, loss to follow-up, re-intervention rate, incidence of infection and mortality were similar to other studies.Conclusion: Intrathecal baclofen infusion pumps are safe and effective in the treatment of spasticity. Infusion pumps provide a high level of satisfaction regarding treatment and quality of life.
publishDate 2019
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dc.rights.driver.fl_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 32 No. 12 (2019): December; 754-759
Acta Médica Portuguesa; Vol. 32 N.º 12 (2019): Dezembro; 754-759
1646-0758
0870-399X
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