Anesth Pain Med.  2016 Oct;11(4):399-403. 10.17085/apm.2016.11.4.399.

The effect of intrathecal baclofen single injection on neuropathic pain

• Lee CA
• Kim HS
• Kim HY
• Lee GG

• KMID: 2358339
• DOI: http://doi.org/10.17085/apm.2016.11.4.399

Abstract

BACKGROUND
Baclofen is a gamma-aminobutyric acid B-receptor agonist, which is usually used for patients with spasticity or patients with nerve injury inducing both spasticity and neuropathic pain. Both oral administration and intrathecal injection via a continuous infusion pump are common treatment methods. The aim of this study was to evaluate the effectiveness of a series of three individual injections of intrathecal baclofen for neuropathic pain without spasticity.
METHODS
Thirty-one patients with neuropathic pain were treated with a series of three monthly individual injections of intrathecal baclofen without pump implantation A dose of 50 µg of baclofen was used. 10-cm visual analog scale (VAS) scores of spontaneous pain, allodynia, and hyperalgesia were recorded a week after each injection. Vital signs were monitored to detect any hemodynamic changes, and a myelogram was performed to detect any undesirable cerebrospinal fluid leakage. All patients were hospitalized for at least one day following each injection for close observation and to control any adverse effects.
RESULTS
VAS scores of spontaneous pain, allodynia, and hyperalgesia decreased significantly (P < 0.001). The major complications were general weakness, sleepiness, and urinary retention; most of these resolved within one day without any further serious symptoms.
CONCLUSIONS
A series of three individual intrathecal baclofen injections was effective for those patients who suffered from neuropathic pain without spasticity or dystonia; no serious complications were observed. However, the average satisfaction score recorded for spontaneous pain was lower than those for allodynia and hyperalgesia.

Keyword

Allodynia; Baclofen; Hyperalgesia; Intrathecal injection; Spontaneous pain

MeSH Terms

Administration, Oral
Baclofen*
Cerebrospinal Fluid Leak
Dystonia
gamma-Aminobutyric Acid
Hemodynamics
Humans
Hyperalgesia
Infusion Pumps
Injections, Spinal
Muscle Spasticity
Neuralgia*
Urinary Retention
Visual Analog Scale
Vital Signs
Baclofen
gamma-Aminobutyric Acid

Figure

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  Fig. 1 Visual analog scale scores (VAS) of spontaneous pain before the treatment and each treatment. The box plot shows a statistically significant decrease of the VAS scores for each treatment. *P < 0.001 compared with initiation of treatment. VAS: visual analog scale.

• 

  Fig. 2 Visual analog scale scores (VAS) of allodynia pain before the treatment and each treatment. The box plot shows a statistically significant decrease of the VAS scores for each treatment. *P < 0.001 compared with initiation of treatment. VAS: visual analog scale.

• 

  Fig. 3 Visual analog scale scores (VAS) of hyperalgesia before the treatment and each treatment. The box plot shows a statistically significant decrease of the VAS scores for each treatment. *P < 0.001 compared with initiation of treatment. VAS: visual analog scale.

• 

  Fig. 4 The bar chart shows the incidence of adverse effects in percentages.

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