Delivery of Intrathecal Morphine Through Baclofen Pump for Perioperative Analgesia

A number of children with abnormal tone are implanted with pumps that deliver baclofen to the intrathecal space through an attached catheter. These pumps contain a catheter access port that allows for withdrawal or introduction of fluids to the intrathecal space. Patients treated with baclofen pumps often also present with neuromuscular scoliosis or other conditions that require extensive surgery and perioperative analgesia. In this article, we describe cases in which intrathecal morphine (Duramorph) was delivered through implanted baclofen pumps to manage perioperative pain. We demonstrate that baclofen pumps can be used to deliver intrathecal morphine for effective perioperative analgesia with minimal risk of complications such as respiratory depression, pruritis, and nausea/vomiting. We also highlight steps which must be taken to ensure safety when using this technique.