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Intrathecal morphine therapy related granulomas: two case reports
Vincent J Miele1, Kenneth Price, Stephen Bloomfield
1Dept. of Neurosurgery, West Virginia University School of Medicine, Morgantown, USA.
The West Virginia Medical Journal
|February 9, 2007
Summary
Intrathecal morphine infusions for benign pain are safe but can cause rare granulomatous masses at catheter tips in patients with longer lifespans. This complication requires careful monitoring in long-term intrathecal drug delivery system (IT-DDS) therapy.
Area of Science:
- Neurology
- Pain Management
- Neurosurgery
Background:
- Intrathecal morphine infusions historically treated short-life expectancy patients.
- Current use extends to benign pain sources, with documented safety.
- Longer patient survival reveals new complications.
Observation:
- Granulomatous masses at catheter tips are an uncommon complication of intrathecal therapy.
- Two cases observed at West Virginia University Hospital in over 700 intrathecal drug delivery system (IT-DDS) implantations since 1989.
- Patients experiencing these masses have longer life spans.
Findings:
- The development of granulomatous masses is a potentially serious complication.
- These masses form at the tip of the intrathecal catheter.
- Longer patient survival increases the risk of encountering such complications.
Implications:
- Highlights the need for vigilance regarding granulomatous mass formation in long-term IT-DDS therapy.
- Suggests further research into the etiology and prevention of these masses.
- Informs clinical practice for managing patients with intrathecal drug delivery systems for chronic pain.
