Combined intrathecal baclofen and morphine infusion for the treatment of spasticity related pain and central deafferentiation pain.
OBJECTIVE
Complex pain syndromes due to spasticity and central deafferentation often fail to respond to medical therapy and create challenging problems in the pain management. So far, only spasticity associated musculosceletal pain has been reported to respond to intrathecal baclofen application [1, 2].


METHODS
We report the treatment of severe neuropathic pain in a patient with ED and the combined intrathecal application of baclofen and morphine in 5 patients with severe spasticity related pain.


RESULTS
Continuous intrathecal baclofen infusion resulted in a pain free period of 20 months in the patient with ED. Patients with spasticity treated with intrathecal application of baclofen and morphine were pain free for a mean period of 2 years.


CONCLUSIONS
Intrathecal baclofen and morphine application proved to be effective in spasticity related and central deafferentation pain and should therefore be considered in the management of these patients.
Gatscher
S
S
Department of Neurosurgery, Philipps-University Hospital, Marburg, Germany.
Becker
R
R
Uhle
E
E
Bertalanffy
H
H
D000344:Afferent Pathways; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D001418:Baclofen / Q000008:administration & dosage* / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000188:drug therapy; D003714:Denervation; D004359:Drug Therapy, Combination; D006801:Humans; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use; D009125:Muscle Relaxants, Central / Q000008:administration & dosage* / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care
D000701:Analgesics, Opioid; D009125:Muscle Relaxants, Central; D009020:Morphine; D001418:Baclofen