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pISSN 2005-9159
eISSN 2093-0569
eISSN 2093-0569
Korean J Pain 2012; 25(1): 47-51
Published online January 31, 2012 https://doi.org/10.3344/kjp.2012.25.1.47
Copyright © The Korean Pain Society.
Seok Myeon Rhee, MD, Eun Joo Choi, MD, Pyung Bok Lee, MD, and Francis Sahngun Nahm, MD*
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Correspondence to: Francis Sahngun Nahm, MD. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam 463-707, Korea. Tel: +82-31-787-7499, Fax: +82-31-787-4063, hiitsme@snubh.org
Received: October 19, 2011; Revised: November 29, 2011; Accepted: December 1, 2011
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.
Keywords: implantable infusion pump, indwelling catheter, morphine, spinal injection
