38. Use of intrathecal clonidine infusion, using a telemetric pump, in patients with side effects or tolerance to narcotics

G. D'Aleo, C. Rifici, A. Kofler, S. Marra, M. Kronenberg, L. Saltuari, E. Sessa, P. Bramanti

Research output: Contribution to journalArticlepeer-review

Abstract

Epidural and intrathecal morphine administration has been shown to relieve metastatic cancer and nonmalignant chronic pain when conventional analgesic therapy or spinal cord stimulation are ineffective or contraindicated. If increased tolerance to the spinal narcotic agonist develop or serious side effects appear, a second narcotic agonist or the alpha2-agonist clonidine may be added or substituted, in an epidural or intrathecal infusion, as an analgesic for both malignant and non malignant pain. In this report we document the use, as analgesic, of an intrathecal infusion of clonidine in 7 patients with tolerance or side effects with morphine, using a peristaltic roller pump powered by a lithium thionyl chloride battery with a drug reservoir volume of 18 ml. An electronic circuit allows for external radio frequency control of different application models (bolus, continuous, complex) and flow rates. The mean dosage was 187 ug/die (max 470 ug/die, min 42 ug/die) with a good control of pain (mean VAS from 9 to 2) . The follow-up was ca 2 years. The mode-infusion was continuous for all patients. Sometime we observed tiredness and hypotension. No tolerance to clonidine was observed.

Original languageEnglish
Pages (from-to)236
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume18
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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