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Reversible coma in children after improper baclofen pump insertion.

Keith J Anderson1, Jean-Pierre Farmer, Karen Brown

  • 1Department of Pediatric Anaesthesia, Neurosurgery and Oncology Montreal Childrens' Hospital, McGill University Healthcare Center, Montreal, Quebec, Canada. maria.distefano@muhc.mcgill.ca

Paediatric Anaesthesia
|June 13, 2002
PubMed
Summary

Delayed coma occurred in children after baclofen pump surgery due to accidental intrathecal baclofen overdose. This report details the events and suggests methods to prevent this serious complication.

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Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Pharmacology

Background:

  • Intrathecal baclofen pumps are used for managing spasticity in children.
  • Postoperative complications can arise from device implantation and medication delivery.

Observation:

  • Five out of nine pediatric patients developed delayed-onset coma after baclofen pump surgery.
  • This complication occurred consecutively in the patient cohort.

Findings:

  • The coma was suspected to result from inadvertent intrathecal baclofen bolus administration.
  • Improper surgical technique is implicated as the cause of the overdose.

Implications:

  • Highlights a critical risk associated with intrathecal baclofen pump surgery in children.

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  • Suggests the need for refined surgical techniques and protocols to prevent accidental bolus administration.
  • Emphasizes the importance of vigilant postoperative monitoring for neurological changes.