Related Experiment Video
Updated: Jun 20, 2026
04:41
Lumbar Intrathecal Injection of SOD1-ASOs for Precise CNS Targeting and Predictive Efficacy in Human SOD1-G93A ALS Mice
Published on: February 24, 2026
[Intrathecal baclofen therapy. Overdose during replacement of a medication pump]
K Kramer1, M Weber, A Koulousakis
1Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln, Köln. kathrin.kramer@uk-koeln.de
Der Anaesthesist
|September 5, 2009
Summary
Intrathecal baclofen (ITB) therapy can cause serious anesthesiological complications, including hypothermia and respiratory distress. Prompt reduction of baclofen dosage resolved these adverse effects in a pediatric patient.
Area of Science:
- Anesthesiology
- Neurology
- Pharmacology
Background:
- Intrathecal baclofen (ITB) therapy is increasingly utilized for managing spasticity in conditions like multiple sclerosis and cerebral palsy.
- Anesthesiological management during pump procedures requires awareness of potential ITB-related complications.
Observation:
- An 11-year-old boy with spasticity experienced hypothermia, hypotonia, bradycardia, and dyspnea during general anesthesia for baclofen pump exchange.
- These symptoms were attributed to an intraoperative bolus of intrathecal baclofen.
Findings:
- Reducing the baclofen administration rate led to the complete resolution of the patient's symptoms without sequelae.
- This case highlights the critical need for vigilance regarding ITB dosage during anesthesia.
Implications:
- Anesthesiologists and emergency personnel must be educated on the potential adverse effects of ITB therapy.
- Awareness and prompt management are crucial for patient safety during ITB therapy and related procedures.
Related Concept Videos
01:29Drug Delivery: Parenteral Route
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
01:20Desensitization and Tachyphylaxis
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
Several...
Several...
01:28IV Infusion to Oral Dosing: Conversion Methods
The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
01:21Drug Accumulation During Multiple Dosing: Repetitive IV Injections
Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
01:16Insulin: Dosing Regimen and Adverse Effects
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...