Complications of intrathecal drug delivery systems

Objectives. To report complications associated with implant of the intrathecal drug delivery systems (IDDS). Patients and Methods, A retrospective review of the implant database was undertaken to determine various complications associated with the IDDS. A fetal of 122 patients were reviewed, 97 included in the final analysis, 25 excluded due to incomplete data. The complications of excluded patients were reviewed separately. The complications were divided in to categories pharmacologic, equipment, procedural, programming errors and psychological. The drugs used were morphine, dilaudid, fentanyl, sufentanil, baclofen, and marcaine. Results. There were 60 men and 37 women. A total of 43 patients reported various complications. Most common were transient pharmacologic side effects (n = 33), procedural (n = 5),equipment (n = 16), programming (n = 2), and psychological (n = 3). The most serious procedural complication was Staphylococcus aureus meningitis (n = 1). Catheter disconnection and leakage was noted in (n = 6) patients. Two programming errors were related to increase in drug concentration with failure to reduce the dose. Seven pumps were explanted, including three due to distorted body image. Conclusion. IDDS are effective and safe devices for pain management, The complications associated with implants are mostly pharmacological and transient.