Description of Event or Problem · 1
CRUIKSHANK, ET AL. "INTRAVENOUS DIAZEPAM INFUSION IN THE MANAGEMENT OF PLANNED INTRATHECAL BACLOFEN WITHDRAWAL." DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY. 2007; 49: 626-628. PT'S PUMP HAD TO BE REPOSITIONED AFTER X-RAY SHOWED ROTATION. THE ARTICLE DESCRIBES A MALE WITH CEREBRAL PALSY WITH QUADRIPLEGIA HAD A BACLOFEN PUMP IMPLANTED 5 YEARS PREVIOUSLY. A YEAR PREVIOUSLY, HIS PUMP REQUIRED REPOSITIONING AS X-RAYS CONFIRMED THAT IT HAD ROTATED. SIX MONTHS LATER, THE PUMP HAD SLIPPED AGAIN AND AN AREA OF PRESSURE NECROSIS AND CELLULITIS HAD DEVELOPED. IN VIEW OF THE FACT THAT HE WAS DUE FOR A NEW PUMP INSERTION THAT YEAR, AS HIS PUMP BATTERIES WERE DUE TO RUN OUT, IT WAS DECIDED TO REMOVE ELECTIVELY HIS PUMP TO ALLOW THE INFECTION TO RESOLVE. POST OP HE WAS COMMENCED ON A DIAZEPAM INFUSION WHICH WAS DISCONTINUED AFTER 42 HOURS, HE WAS THEN COMMENCED ON ORAL BACLOFEN. THE PROCEDURE AND POST OP COURSE WERE UNEVENTFUL. HE DID NOT DEVELOP WORSENING SPASTICITY OR DYSTONIC SPASMS.