Spinal opiate administration: a case of catheter misplacement.
Continuous spinal opiate administration via permanently implantable drug delivery devices has been proven to provide profound analgesia for chronic pain conditions. We present a case in which the catheter of an implantable subarachnoid device was misplaced into the subdural/extra-arachnoid space despite the free flow of cerebrospinal fluid. This was verified by x-ray dye studies. It is postulated that this misplacement of the catheter likely occurred as a result of recent lumbar punctures the patient had undergone. Extravasation of cerebrospinal fluid created a false space and contributed to the misplacement and ultimate failure of the device to provide analgesia.
Tom
C M
CM
Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107.
Arias
L M
LM
Barolat
G
G
D000328:Adult; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002908:Chronic Disease; D004868:Equipment Failure; D005260:Female; D006801:Humans; D009020:Morphine / Q000008:administration & dosage* / Q000134:cerebrospinal fluid / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D011859:Radiography; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000187:drug effects*; D013346:Subarachnoid Space; D013355:Subdural Space
D009020:Morphine