Treatment of severe tetanus by continuous intrathecal infusion of baclofen.

Brock, Helen; Moosbauer, W.; Gabriel, C; Necek, S; Bidal, D

doi:10.1136/jnnp.59.2.193

Cited by 17 publications

(11 citation statements)

References 3 publications

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“…This is only the second case report in the United States of use of an implantable pump with internalized catheter, versus an externalized catheter, for ITB delivery. The use of baclofen in cases of severe tetanus has been reported in Europe, Asia, Africa, and Australia in bolus form or via an external catheter . Only one other case has been documented in which severe tetanus was successfully treated via an implantable pump with internalized catheter for intrathecal delivery .…”

Section: Discussionmentioning

confidence: 99%

Treatment of Severe Tetanus With Intrathecal Baclofen via Implantable Infusion Device: A Case Report

Dapul

Patel

Pannu

et al. 2014

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 99%

Treatment of Severe Tetanus With Intrathecal Baclofen via Implantable Infusion Device: A Case Report

Dapul

Patel

Pannu

et al. 2014

Neuromodulation: Technology at the Neural Interface

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“…Two other drugs, baclofen and dantrolene, have been used for the control of spasms without the need for sedation and artificial ventilation but have their own limitations. Baclofen, a gaba B agonist, has been used intrathecally in tetanus both as an adjunct to sedation and paralysis [28,29] and also as the sole therapy [8,9]. Muller et al [8], using continuous infusions, were able to control spasms without causing sedation or ventilatory depression in two patients.…”

Section: Discussionmentioning

confidence: 99%

Magnesium sulphate for control of spasms in severe tetanusCan we avoid sedation and artificial ventilation?

Attygalle

Rodrigo

1997

Anaesthesia

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SummaryA prospective pilot study was undertaken to investigate the ability of magnesium sulphate to control the spasms of severe tetanus without the need for sedation and artificial ventilation. All eight patients admitted with severe tetanus to our intensive care unit within the last year were given magnesium sulphate intravenously as a 5-g loading dose followed by an infusion of 2-3 g h ¹1 . The infusion rate was increased to control spasms while retaining the patella tendon reflex, which proved a valid guide to avoid overdose. Spasms were effectively controlled and serum magnesium concentrations were maintained within the therapeutic range. Spontaneous ventilation was adequate, ventilatory support being required only for the management of lung pathology. There was no evidence of cardiovascular instability due to sympathetic over activity. No supplementary sedation was required for the control of spasms or autonomic dysfunction during magnesium therapy. We conclude that magnesium sulphate can be used as the sole agent for the control of spasms in tetanus without the need for sedation and artificial ventilation.

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“…Most of the patients in other studies started treatment with a bolus dose in the range of 50-1000 m g (Table 2) [17,[21][22][23][24][25][26][27][28][29][30][31]. Some patients were treated thereafter only by repeated bolus injections on consecutive days [25,27,28], while other patients received a continuous infusion of baclofen.…”

Section: Discussionmentioning

confidence: 99%

“…baclofen during treatment for spasticity [33]. The authors discuss a possible antagonizing effect of flumazenil on the spinal effects of baclofen [31]. baclofen, remained comatose even after 2 mg flumazenil was administered 3 days after the diazepam infusion had been stopped.…”

Section: Baclofen and Benzodiazepinesmentioning

confidence: 99%