Korean J Pain.  2012 Jan;25(1):47-51. 10.3344/kjp.2012.25.1.47.

Catheter Obstruction of Intrathecal Drug Administration System: A Case Report

• Rhee SM
• Choi EJ
• Lee PB
• Nahm FS

• KMID: 2278116
• DOI: http://doi.org/10.3344/kjp.2012.25.1.47

Abstract

Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.

Keyword

implantable infusion pump; indwelling catheter; morphine; spinal injection

MeSH Terms

Adult
Analgesics, Opioid
Catheter Obstruction
Catheters
Catheters, Indwelling
Failed Back Surgery Syndrome
Humans
Infusion Pumps, Implantable
Injections, Spinal
Morphine
Pain, Intractable
Stress, Psychological
Analgesics, Opioid
Morphine

Figure

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  Fig. 1 Movement of the Rotor examined by a fluoroscope (arrow). Before (A) and after (B) the priming bolus injection. The rotor was functioning normally.

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  Fig. 2 (A) Removal of the catheter from the patient. The side hole of the catheter was plugged. (B) Magnified picture of the catheter tip.

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