Different individuals, mostly children, are dealing with muscle stiffness, spasms, nerve diseases, etc. Baclofen or Lioresal, a medication used to relax muscles, is also used to treat conditions which relate to muscle dysfunctions, also called spasticity, as well as other neurological diseases. Baclofen pump is a device used to administer Baclofen into the central nervous system to the spinal cord. The process begins with a Baclofen pump surgery, and the volume and frequency of the medication deposited into the intrathecal space – the area of the spinal cord surrounded by fluid, is determined by a qualified doctor.
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What Is Baclofen Pump?
As aforementioned, it is a device that deposits the drug (Lioresal) into the spinal cord system. The system is made up of an intrathecal programmable Baclofen pump and a catheter. The catheter is used during the surgery to deliver liquid medication into the nervous system. The rate and volume of the medication deposited during the Baclofen pump placement are usually dependent on the disease and level of care a client requires. The drug, Lioresal is derived chemically from GABA neurotransmitter y- aminobutyric acid.
Intrathecal Baclofen Pump Eligibility
Individuals in need of Baclofen pumps may differ depending on the kind of treatment needed. Most clients choose the Lioresal injection after gaining little to no relief using oral medications. The two main struggles treated using the Baclofen pump system is:
- Severe spasticity
These are involuntary stiff muscle movements due to muscle disorder. The symptoms may range from painful to mild tightness and stiffness of muscles, mostly in the legs. Causes of spasticity include:
- Spinal Cord Injury
- Brain Injury
- Multiple Sclerosis
- Cerebral Palsy, and more.
Individuals may require a Baclofen pump for cerebral palsy as it treats patients dealing with severe spasticity and movement control issues.
The disease originates when there is a dysfunction in the part of the brain called the basal ganglia. They are painful and uncontrollable spasms caused by involuntary muscle contractions due to improper communication of the nerve cells.
Individuals may need a Medtronic Baclofen pump for other reasons such as:
- Oral medication becomes ineffective after some time
- There might not be an adequate improvement before intolerable side effects develop.
The Baclofen Pump Procedure
Before the Baclofen intrathecal pump surgery takes place, clients must complete multiple consultations with their doctors. During these consultations, the individual will be tested using different dosages to determine the appropriate amount of the medication needed and to avoid any Baclofen pump complications.
A trained nurse or doctor injects the individual with the required dosage. The individual is closely observed all through the night. A trained practitioner will administer anesthesia to the client, and the procedure may take one to two hours. The pump placement is dependent on the surgeon as it can either be higher or lower in a body.
How long is the Recovery Time?
Baclofen pump recovery time takes from 2 to 8 weeks depending on the individual. Regular checkups occur during this time and after. After completion of the surgery, it is not unusual for individuals to take time off to heal before going back to normal activities.
After healing properly, individuals who have undergone Baclofen pump surgery are required to make scheduled visits to the doctor. These visits will allow the doctor to monitor the effectiveness as well as adjust the medication level.
Management Of Baclofen Pump
The checkups are scheduled every week, and a nurse practitioner adjusts the dosage until an appropriate one is set and also to check the incision. Baclofen pump refill takes place every 1-6 months depending on the frequency. The device is refilled using a needle, inserted into the port and the medication administered.
Intrathecal Baclofen Therapy: Pros And Cons
Intrathecal therapy usually becomes an option after patients have tried other oral medication methods such as Klonopin, Valium, Dantrium, and even the Baclofen 20mg tablet. Like any other medication, Baclofen pump side effects may vary from person to person.
- The device works continuously and delivers appropriate amounts of Lioresal.
- Intrathecal therapy utilization is a more effective option than the oral administration as Baclofen works better this way.
- It is a better route to take that utilizing more invasive and uncomfortable forms of treatment such as Deep Brain Stimulation (DBS).
- Clients can complete daily activities as it has little to no effect.
- If it becomes too much, the device can be removed and replaced.
- Clients may need to visit the doctor regularly for checkups and pump refills.
- The incision can become infected after surgery, and this might become a problem.
- Individuals might feel insecure as the device can be seen under clothing.
Experiencing Baclofen Pump Withdrawal
Baclofen pump withdrawal may occur if an individual is not careful or vigilant. Experiencing a withdrawal is more likely to happen than experiencing a Baclofen overdose. The withdrawal symptoms may become life-threatening if not handled accordingly. Symptoms include:
Although Lioresal may be used to treat patients suffering from Alcohol Use Disorder (AUD), it cannot be used together as it may cause drowsiness and dizziness. Combining Baclofen and alcohol is prohibited by doctors and medical practitioners.
How Long To Wait Before a Baclofen Pump Withdrawal Occurs?
Baclofen pump withdrawals may occur in 48 hours after the dosage is reduced or finished. The symptoms may occur for weeks. The length and time vary as it may begin within a few hours of the last dosage or 72 hours after. Doctors advise to not combine gabapentin and Baclofen at all as it might cause dizziness, drowsiness in a patient.
Precautions To Take After Undergoing Baclofen Intrathecal Pump Surgery
After undergoing surgery, several precautions have to be taken to prevent overdose, withdrawals, Baclofen side effects, and many more. Also cautions for conducting other medical procedures while having a Baclofen pump is essential. Some of these include:
- Sudden movements such as twisting and bending should be avoided to prevent breaking or kinking the tube and causing a break in the medication transmission.
- Taking part in activities such as driving and operating machines should be avoided as the medication may cause drowsiness.
- Mixing Baclofen and Xanax may result in side effects such as drowsiness, dizziness, and even impaired thinking.
- Avoid diving below 10 meters into the ocean as the pump flow decreases when pressure increases.
Baclofen Pump MRI Safety
Before scheduling an MRI (Magnetic Resonance Imaging) scan, clients are advised to contact their doctors as MRI may cause the device to stop, causing the flow of Lioresal to stop as well. Proper pump MRI safety precautions must be adhered to before the scan begins. Other medical procedures that require precautions include Hyperbaric Oxygen Therapy and Diagnostic Ultrasound.
Can Baclofen Overdose Occur During Inthractal Intake?
NCBI research shows that ingesting over 200 mg of Lioresal is dangerous as it may cause individuals to experience seizures, comas, and even develop delirium. These effects may cause such individuals to be admitted in the hospital for long periods.
Baclofen won’t show up on a drug test as it is a nerve medication and is eliminated via urine. It will only show up if it is the drug specifically being tested and if the test is done one to two days after a Baclofen injection.
Pricing And Insurance For Intrathecal Lioresal Therapy
Baclofen pump cost varies depending on the location. The frequency at which the device is refilled or replaced is also a determinant on the cost it accrues.
- A refill kit cost from $50 to $150
- According to ISPOR, a one-year treatment of intrathecal Baclofen therapy may cost approximately $26,000 including surgery, follow up sessions, and tests.
Most insurances providers including Medicare and Medicaid cover the cost for the device and the surgery. Clients can contact their private insurance providers to determine if the medication, follow up treatments, and surgery is included in their plan.
Deciding to switch to intrathecal Lioresal from oral medication is a decision made by a client’s doctor. Choosing to get Baclofen intrathecal pump surgery may be a good choice in the long run as it works better than the oral form. Other uses for Lioresal include treating hiccups. The recreational use of Baclofen is highly advised against as it is a muscle relaxant.