Neuromodulation : journal of the International Neuromodulation Society
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The approach to intrathecal (IT) drug delivery malfunction is complicated, particularly for iodine-allergic patients. In these situations, the current literature has not addressed the use of IT gadolinium. Case reports exist showing severe neurotoxic manifestations with IT gadolinium use. We sought to provide a resource for chronic pain physicians treating an iodine-allergic patient and considering the use of IT gadolinium. ⋯ Herein, we provide guidance on IT gadolinium usage and a framework for IT pump malfunction in iodine allergic patients.
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There are an ever-increasing number of patients who have implanted devices for targeted delivery of drug therapy to the intrathecal space for the management of spasticity or chronic pain. This leads to a growing number of people with implanted pumps presenting for procedures and surgeries, yet there is a paucity of consolidated information available to describe the appropriate precautions and patient management during this period. ⋯ Our article outlined perioperative considerations when dealing with a patient with intrathecal pump undergoing surgical or imaging modality.
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There are an ever-increasing number of patients who have implanted devices for targeted delivery of drug therapy to the intrathecal space for the management of spasticity or chronic pain. This leads to a growing number of people with implanted pumps presenting for procedures and surgeries, yet there is a paucity of consolidated information available to describe the appropriate precautions and patient management during this period. ⋯ Our article outlined perioperative considerations when dealing with a patient with intrathecal pump undergoing surgical or imaging modality.