Intrathecal Baclofen Pump Perioperative Management: Case Report and Literature Review

Abstract

Background The use of intrathecal baclofen pumps (ITBP) has become increasingly common worldwide for the treatment of severe spasticity. Increased prevalence of patients using ITBPs makes encounters ever more common with surgical teams, these surgical interventions may be related to ITBP manipulation or completely unrelated to these devices. The anesthetist must be familiar with the normal functioning of ITBPs and be aware of baclofen pharmacokinetics in the cerebrospinal fluid, the occurrence of baclofen overdosing or withdrawal, and the potential pharmacological interactions between baclofen and drugs commonly used intraoperatively. We present the case of a successful management of a patient with chronic use of an ITBP which had to be suspended before undergoing a surgical procedure to perform intraoperative neuromonitoring to guide the surgical intervention. A good communication and organization of the multidisciplinary team improves the prognosis of the patient and reduces morbidity and mortality.