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In order to treat severe to moderate-severe spasticity that is unresponsive to oral medicines, baclofen pump implantation is performed surgically to implant a pump that delivers baclofen directly to the spinal fluid.

By continuously delivering small doses of baclofen directly to the spinal fluid, it increases therapeutic benefits while causing fewer and less severe side effects compared with oral medication.

A pump and a catheter deliver the drug from the pump into the spinal fluid in the baclofen pump system. The pump is a round metallic disc that is surgically placed under the skin of the abdomen (about 1 inch thick and 3 inches in diameter).

The aim of Baclofen pump implantation is to reduce spasticity caused by multiple sclerosis, spinal cord injuries, or other neurological conditions.

What is Baclofen?

Baclofen is a medically prescribed pain reliever that is used to treat pain and spasticity (muscle stiffness and tightness) caused by multiple sclerosis, spinal cord injuries, and other spinal cord disorders. Baclofen belongs to the skeletal muscle relaxant class of drugs. Baclofen works by acting on the nerves in the spinal cord, reducing the amount and intensity of muscular spasms caused by multiple sclerosis or other spinal disorders. It also helps with pain relief and muscle movement.

Some of the baclofen’s adverse effects include:

  1. Drowsiness
  2. Dizziness
  3. Drowsiness
  4. Weakness
  5. Headache
  6. Nausea
  7. Constipation
  8. Frequent Urination

What Is The Best Way to Take This Medication?

Baclofen is available as a tablet and a liquid solution to be taken by mouth. It’s commonly taken three times a day, at regular intervals. Follow the directions on your prescription label carefully, and if there is anything you do not understand, ask your doctor or pharmacist to explain it to you. Baclofen should be taken exactly as prescribed. Do not take more or less of it, or take it more frequently than your doctor has suggested.

To correctly measure and take your baclofen solution dose, use an oral syringe (measuring instrument). If your prescription does not come with an oral syringe, ask your pharmacist for one.

Even if you feel fine, keep taking baclofen. Stopping baclofen without consulting your doctor is not a good idea, especially if you’ve been taking significant doses for a long time. Seizures, fever, disorientation, muscle rigidity, and hallucinations may occur if you stop taking this drug suddenly. Your doctor will most likely wish to progressively reduce your dose.

Who is The Good Candidate for Baclofen Pump Implantation?

If you have severe spasticity and are not responding to oral drugs, your doctor may refer you for a consultation to see if Baclofen Pump Implantation is a better fit for you. A physician and physical/occupational therapists frequently conduct detailed clinical assessments. These experts provide information about BPT that can be discussed.

After that, a test injection is given to further assess the baclofen pump implantation suitability. A spinal tap is performed, and a little amount of baclofen is administered into the spinal fluid. The medication’s effects are examined a few hours later. These effects are only transient, yet they provide extremely useful information that aids decision-making.

What Are the Benefits of Baclofen Pump Implants?

  1. Reduces the need for oral drugs.
  2. Assists in the reduction of the negative effects of oral drugs.
  3. The trial lasts four to seven days to determine the effectiveness of the therapy.
  4. The surgery is performed without the need for hospitalization.
  5. Treatment is reversible, and the implant can be withdrawn at any moment.
  6. There is no need for a surgical incision.
  7. There is no need to rest for an extended period of time.
  8. There are no major adverse effects.

Advantages

  1. Because the drug is brought into close contact with the spinal cord during implant surgery, it is usually far more successful in managing the symptoms of spasticity.
  2. The medicine is administered constantly throughout the operation, day and night, providing more consistent symptom relief.
  3. In most situations, implanting a pump has lesser negative effects than taking baclofen orally, especially when high dosages are required to treat severe spasticity.
  4. The baclofen pump implantation procedure is very versatile, allowing for more precise baclofen dosing and the ability to deliver different amounts at different times of the day.
  5. In comparison to other surgical therapies, the baclofen pump is reversible because it may be changed off or stopped if needed.

How Long a Patient Will Stay in the Hospital?

Patients stay in the hospital for a few days after surgery. The time it takes for a patient to resume regular activities is largely determined by his or her pre-operative condition and age. Once your vital signs have stabilized and you have returned to baseline functioning, you should be allowed to go home. The pump will need to be replenished every couple of months, depending on the size, concentration, and dose of the pump. Refills are completed in the office with a syringe and needle and take around fifteen minutes. Baclofen doses are modified at that time based on the side effects observed.

Know More – How To Refill Baclofen Pump 

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Procedure

The baclofen drug is administered into the spinal canal (with a small needle) during a baclofen implantation procedure, and you are evaluated by the medical team over many hours to see how well the medicine relieves the spasticity. If you have a positive effect, you may be a candidate for a permanent pump to provide the medication.

While the patient is under general anesthesia, the pump is implanted beneath the covering of the abdominal muscles. A short catheter is then introduced into the spinal fluid area through a needle and threaded upward. The catheter is then dug down under the skin and attached to the pump in the belly. The pump is filled with the drug baclofen and is programmed by a computer to release a certain dose decided by the physician on a continuous basis.

When the wound is closed with suture material (stitches) or surgical staples, the procedure is finished. If staples or non-absorbable sutures were used to close the outside incision, they will need to be removed once the wound has healed. It normally takes 1-2 hours to complete the operation. In additional significance, the baclofen pump implantation cost in India is quite affordable as compared to other European countries.

The Most Important Frequently Asked Questions

Q: How Painful Is Baclofen Pump Surgery?

A: You’ll experience some discomfort and tenderness at the pump and catheter sites after surgery. Your doctor may give pain relievers and medicines to avoid infection as a result of the procedure. If you detect any swelling, pain, or redness near your incision, call your doctor.

Q: Can a Baclofen Pump Be Removed?

A: Baclofen pump implantation programming is extremely adaptable, allowing for more precise baclofen dosing and the delivery of multiple doses at different times of the day. Baclofen pump implantation is reversible, unlike other surgical therapies, because the pump can be turned off and removed if necessary.

Q: How Long Is Recovery from Pain Pump Surgery?

A: After the pump is installed, the recovery time is usually 6–8 weeks. You may feel a little uncomfortable at first, and your motions may be restricted.

Q: What Are the Side Effects of the Baclofen Pump?

A: The use of a baclofen pump is typically safe, and problems are uncommon, but they do occur.

  • There’s a chance you’ll have a poor anesthetic reaction.
  • There is a chance of bleeding
  • There’s a chance that spinal fluid will leak.
  • Infection of the pump, catheter, or incision is a possibility (from surgery)
  • Bladder control alterations that are minor (usually temporary)

Q: How Do You Test a Baclofen Pump?

A: A modest dosage of Lioresal® Intrathecal (baclofen injection) will be injected into the area where a fluid circulates around your spinal cord during the test. For at least 6 to 8 hours, your reaction will be watched. The effects can last anywhere from 30 minutes to an hour, and they usually last 4 to 8 hours.

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