Study Design: Case report. Patient Sample: A 42year-old Caucasian male. Results: Catheter-tip granuloma formation is possible despite a normal catheter access study in patients with intrathecal (IT) infusion systems and its recurrence is possible after surgical excision. Increasing concentrations of hydromorphone from 50 mg/ml to 100 mg/ml without altering the daily dosage may have precipitated...

Pain is prevalent in advanced malignancies; however, some patients cannot get adequate pain relief by conservative routes of analgesic administration or experience serious side effects related to high dose of opioids. For those who have exhausted multimodal conservative analgesic, intrathecal drug delivery is an alternative intervention for truly effective pain management. The objective of this...

OBJECTIVE: Ropivacaine, a local anesthetic with duration of action of 2-3 hours, has shown greater selectivity for sensory blockade along with lower systemic toxicity as compared to bupivacaine when used for spinal anesthesia. This study was aimed to compare the intrathecal efficacy and safety of 0.75% isobaric ropivacaine for cesarean delivery with 0.5% heavy bupivacaine in parturients. MATERI...

The aim of this principally experimental study is to understand from fluid mechanic principles why an insignificant anesthetic dose administered as a short bolus into the cerebrospinal fluid inside the subarachnoid space provides greater pain relief than a larger dose continuously injected over a longer period. The subarachnoid space is modeled as an annular gap of constant or slowly varying cr...

BACKGROUND Continuous intrathecal labor analgesia produces rapid analgesia or anesthesia and allows substantial flexibility in medication choice. The US Food and Drug Administration, in 1992, removed intrathecal microcatheters (27-32 gauge) from clinical use after reports of neurologic injury in nonobstetric patients. This study examined the safety and efficacy of a 28-gauge intrathecal cathete...

We studied the effects of spinal intrathecal fentanyl on oxytocin secretion in 20 healthy women prior to an elective caesarean delivery at term under spinal anaesthesia. The women were randomly allocated into two groups with respect to spinal anaesthesia. Group I (n=10) received intrathecal bupivacaine (15 mg) plus fentanyl (25 microgram), and Group II (n=10) received intrathecal bupivacaine (1...

Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathec...

Viral vector-mediated gene transfer, especially using adeno-associated viral (AAV) vectors, is a powerful strategy to manipulate gene expression in vivo in injured neurons. In this chapter we provide two methods to efficiently transduce dorsal root ganglion (DRG) neurons in vivo using AAV. We describe detailed procedures to perform direct injections into specific DRG and delivery via the intrat...