Pain medicine (Malden, Mass.) · 2010
Intrathecal granuloma formation in a patient receiving long-term spinal infusion of tramadol.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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De Andrés José, Tatay Vivò José, Palmisani Stefano, Villanueva Pérez Vicente L, Mínguez Ana
Аннотация
OBJECTIVE: Intrathecal granuloma associated to the tip of subarachnoid catheters implanted in patients receiving long-term spinal infusion is a rare but potentially catastrophic complication. Its development seems to be related to the intrathecal administration of opioid drugs, although not all opioids induce granuloma formation with the same frequency.
DESIGN: Morphine or hydromorphone-related granulomas have been reported extensively in the literature, but there are no data about any of the other opioids currently used in an off-label fashion when first-line drugs are contraindicated.
SETTING AND PATIENTS: In this case, we report the first documented case of intrathecal granuloma formation in a patient receiving long-term spinal infusion of tramadol, and we put forward a hypothesis for its development.
RESULTS AND CONCLUSIONS: Chronic intrathecal administration of high-dose tramadol could cause an inflammatory mass as it can be caused by similar, off-label infusions of morphine or hydromorphone. Additionally, tramadol stimulates the activity of natural killers and the proliferation of lymphocytes.
DESIGN: Morphine or hydromorphone-related granulomas have been reported extensively in the literature, but there are no data about any of the other opioids currently used in an off-label fashion when first-line drugs are contraindicated.
SETTING AND PATIENTS: In this case, we report the first documented case of intrathecal granuloma formation in a patient receiving long-term spinal infusion of tramadol, and we put forward a hypothesis for its development.
RESULTS AND CONCLUSIONS: Chronic intrathecal administration of high-dose tramadol could cause an inflammatory mass as it can be caused by similar, off-label infusions of morphine or hydromorphone. Additionally, tramadol stimulates the activity of natural killers and the proliferation of lymphocytes.