Intrathecal Catheter with Subcutaneous Port for Clonidine Test Bolus Injection

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Abstract
Introduction and Objectives: The objective of this study was to assess the feasibitity, technical data and use of intrathecal catheter implantation with subcutaneous port for clonidine test injections and individual evaluation.Methods: According to approval of the local ethics committee, 9 consecutive SCI patients (6 men, 3 women) had catheter and port implantation between January 1998 and May 1999. All did not respond to systemic drug therapy in combination to self–clean intermittent catheterisation (SCIC). Implantation was done under general anesthesia. Needle and catheter were Medtronic Infusion Synchromed Intraspinal catheter (Indura™, 8703W). Clonidine test injections were allowed at D5.Results: There were no complications during operation. Follow–up was 8.2 months (0.5–17). After clonidine bolus injection test and validation, 6 patients decided to have permanent pump implantation, 2 chose other therapies and one did not tolerate clonidine intrathecal injections for blood arterial pressure side effects.Conclusions: Intrathecal clonidine may represent a useful conservative treatment of both severe bladder hyperreflexia and spinal spasticity. Its short–term effects can be individually evaluated through bolus injection in subcutaneous port before definitive pump implantation.

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