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  1. Article ; Online: Balancing the benefits of intrathecal baclofen pump surgery with potential postoperative complications.

    Buxton, Kristin

    Developmental medicine and child neurology

    2018  Volume 60, Issue 10, Page(s) 972–973

    MeSH term(s) Baclofen ; Humans ; Infusion Pumps, Implantable ; Injections, Spinal ; Muscle Relaxants, Central ; Muscle Spasticity ; Postoperative Complications
    Chemical Substances Muscle Relaxants, Central ; Baclofen (H789N3FKE8)
    Language English
    Publishing date 2018-03-25
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 80369-8
    ISSN 1469-8749 ; 0012-1622
    ISSN (online) 1469-8749
    ISSN 0012-1622
    DOI 10.1111/dmcn.13756
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Recurrent abdominal dislodgement of intrathecal pump and utility of infraclavicular site for patients with elevated body mass index: illustrative case.

    Buxton, Kristin / Morgan, Ann / Northam, Weston T / Stone, Scellig S D

    Journal of neurosurgery. Case lessons

    2023  Volume 5, Issue 4

    Abstract: Background: Intrathecal baclofen, delivered via implanted pump, has been used to manage spasticity for approximately 40 years. The device is typically subcutaneously or subfascially implanted in the abdominal wall. There are very few cases reported of ... ...

    Abstract Background: Intrathecal baclofen, delivered via implanted pump, has been used to manage spasticity for approximately 40 years. The device is typically subcutaneously or subfascially implanted in the abdominal wall. There are very few cases reported of the pump being implanted in other locations.
    Observations: This case describes the complicated course of a patient presenting with multiple episodes of catheter malfunction related to pump flipping in the abdominal pocket. The patient was successfully treated with repositioning of the pump into the infraclavicular fossa.
    Lessons: Infraclavicular placement of the implanted pump allowed for a more secure pocket base for this patient and less strain applied to the pump, minimizing the risk of disruption of pump positioning and interruption of drug delivery.
    Language English
    Publishing date 2023-01-23
    Publishing country United States
    Document type Journal Article
    ISSN 2694-1902
    ISSN (online) 2694-1902
    DOI 10.3171/CASE22472
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Nurse Practitioner Lead Pediatric Baclofen Pump Program: Impact on Safety and Quality of Care.

    Buxton, Kristin / Morgan, Ann / Rogers, Jayne

    The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses

    2017  Volume 49, Issue 5, Page(s) 324–329

    Abstract: Children with cerebral palsy experience spasticity that can be debilitating and cause significant pain and contractures. Intrathecal baclofen (ITB) therapy can help relieve this spasticity and improve the quality of life for these patients, but it comes ... ...

    Abstract Children with cerebral palsy experience spasticity that can be debilitating and cause significant pain and contractures. Intrathecal baclofen (ITB) therapy can help relieve this spasticity and improve the quality of life for these patients, but it comes with risk. Withdrawal from the medication in case of abrupt discontinuation of delivery can be life-threatening. Regular maintenance of the system is mandatory. Having a program in place to manage the device and support patients helps to ensure their safety. Toward this end, we developed a program with a nurse practitioner (NP) leader to secure the safety and quality of care for patients using ITB therapy. As the program grew, the NP role as an expert in the care and management of ITB pumps became essential to the safety and care of these patients. In addition to the basic outpatient and inpatient management of the baclofen pump, the NP developed a detailed educational program for the patients and leads the quality and safety initiative for the program. The NP is also in a unique position to have intimate knowledge of the patient's condition and build a strong relationship with the patient/family. The NP is able to use this knowledge and relationship as concerns arise that could be related to the ITB therapy. This has greatly improved the safety and quality of care for patients using ITB therapy at our institution.
    MeSH term(s) Baclofen/therapeutic use ; Cerebral Palsy/complications ; Cerebral Palsy/drug therapy ; Child ; Humans ; Infusion Pumps, Implantable ; Muscle Relaxants, Central/therapeutic use ; Muscle Spasticity/drug therapy ; Nurse Practitioners/standards ; Patient Education as Topic ; Patient Safety ; Pediatrics ; Quality of Health Care
    Chemical Substances Muscle Relaxants, Central ; Baclofen (H789N3FKE8)
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632790-4
    ISSN 1945-2810 ; 0888-0395
    ISSN (online) 1945-2810
    ISSN 0888-0395
    DOI 10.1097/JNN.0000000000000310
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The Palliative Use of Intrathecal Baclofen in Niemann-Pick Disease Type C.

    Ubeda Tikkanen, Ana / Buxton, Kristin / Ullrich, Christina K / Stone, Scellig Sd / Nimec, Donna L

    Pediatrics

    2019  Volume 144, Issue 5

    Abstract: Niemann-Pick disease type C is a rare progressive genetic disorder that leads to the abnormal accumulation of lipids within various tissues of the body, including brain tissue and liver. There is a rapid progression of the disease, resulting in severe ... ...

    Abstract Niemann-Pick disease type C is a rare progressive genetic disorder that leads to the abnormal accumulation of lipids within various tissues of the body, including brain tissue and liver. There is a rapid progression of the disease, resulting in severe disability in only a few years after the first symptoms, and survival is not much longer. Spasticity, dystonia, and chronic pain are common findings that severely impact quality of life in these patients. Analgesic management with traditional pain medications is not always effective, and the risk for secondary effects in medically complex patients is high. Liver function is also a limiting factor in these patients. This is a case report of a boy with advanced Niemann-Pick disease type C with developmental regression, cataplexia, and seizures. His severe spasticity made positioning and care difficult, and intense pain required multiple hospitalizations. He had unsuccessfully trialed multiple drugs. An intrathecal baclofen pump was placed without surgical complications and resulted in positive clinical effects. Baclofen pumps have classically been used for spasticity management in adults and children with nonprogressive diseases such as cerebral palsy or spinal cord injury with relatively long life expectancies. In adults, they have been used in patients with multiple sclerosis; however, use in pediatric neurodegenerative diseases has scarcely been reported. The use of intrathecal baclofen in palliative settings might provide an additional resource to provide comfort and quality of life for children with neurodegenerative diseases not only at end-of-life stages but also earlier on.
    MeSH term(s) Baclofen/administration & dosage ; Child ; Fatal Outcome ; Humans ; Infusion Pumps, Implantable ; Injections, Spinal ; Male ; Muscle Relaxants, Central/administration & dosage ; Muscle Spasticity/drug therapy ; Muscle Spasticity/etiology ; Niemann-Pick Disease, Type C/complications ; Niemann-Pick Disease, Type C/drug therapy ; Palliative Care
    Chemical Substances Muscle Relaxants, Central ; Baclofen (H789N3FKE8)
    Language English
    Publishing date 2019-10-21
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2019-1438
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Epidural Analgesia Versus Lumbar Plexus Blockade After Hip Reconstruction Surgery in Children With Cerebral Palsy and Intrathecal Baclofen Pumps: A Comparison of Safety and Efficacy.

    Samineni, Aneesh V / Eklund, Susan E / Miller, Patricia E / Buxton, Kristin / Snyder, Brian D / Matheney, Travis H / Watkins, Colyn J / Stone, Scellig S D / Alrayashi, Walid / Brusseau, Roland / Shore, Benjamin J

    Journal of pediatric orthopedics

    2022  Volume 42, Issue 4, Page(s) 222–228

    Abstract: Background: Epidural analgesia is commonly used for pain control after reconstructive hip surgery, but its use is controversial in the presence of an intrathecal baclofen pump (ITB). The purpose of this retrospective study was to investigate the rate of ...

    Abstract Background: Epidural analgesia is commonly used for pain control after reconstructive hip surgery, but its use is controversial in the presence of an intrathecal baclofen pump (ITB). The purpose of this retrospective study was to investigate the rate of serious anesthetic and postoperative complications as well as the efficacy of epidural analgesia compared with lumbar plexus blocks (LPBs) for pain management after neuromuscular hip reconstruction in children with cerebral palsy (CP) and ITB.
    Methods: Pediatric patients with CP and ITB undergoing hip reconstructive surgery from 2010 to 2019 were retrospectively identified. Patients receiving epidural analgesia were compared with those receiving LPB. Morphine milligram equivalents per kilogram were used as a surrogate measure for pain-related outcomes, as pain scores were reported with wide ranges (eg, 0 to 5/10), making it unfeasible to compare them across the cohort. Postoperative complications were graded using the modified Clavien-Dindo classification.
    Results: Forty-four patients (26/44, 59% male) underwent surgery at an average age of 10.3 years (SD=3.4 y, range: 4 to 17 y). The majority utilized LPB (28/44, 64%) while the remaining utilized epidural (16/44, 36%). There were no differences in rates of serious complications, including no cases of ITB malfunction, damage, or infection. During the immediate postoperative course, patients who received LPB had higher morphine milligram equivalents per kilogram requirements than patients who received epidural analgesia.
    Conclusions: In patients with CP undergoing hip reconstruction surgery with an ITB in situ, epidural anesthesia was associated with improved analgesia compared with LPB analgesia, with a similar risk for adverse outcomes. Epidural catheters placed using image-guided insertion techniques can avoid damage to the ITB catheter while providing effective postoperative pain control without increasing rates of complications in this complex patient population.
    Level of evidence: Level III.
    MeSH term(s) Analgesia, Epidural ; Baclofen ; Cerebral Palsy/complications ; Cerebral Palsy/surgery ; Child ; Female ; Humans ; Lumbosacral Plexus ; Male ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Retrospective Studies
    Chemical Substances Baclofen (H789N3FKE8)
    Language English
    Publishing date 2022-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1681: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  6. Article ; Online: Intrathecal Baclofen Therapy Prior to Spinal Fusion for Patients With Gross Motor Function Classification System IV-V Cerebral Palsy.

    Buxton, Kristin / Difazio, Rachel / Morgan, Ann / McCabe, Margaret / Forbes, Peter W

    Orthopedic nursing

    2018  Volume 37, Issue 2, Page(s) 136–143

    Abstract: Background: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB ... ...

    Abstract Background: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB therapy on the postoperative course following spinal fusion in patients with GMFCS IV-V CP has not been described. This study sought to compare postoperative recovery, including complications, in patients using ITB therapy with those with no ITB therapy.
    Purpose: Evaluate the effect of ITB on the postoperative recovery for patients with GMFCS IV-V CP who undergo spinal fusion for scoliosis.
    Methods: Health records for patients with GMFCS IV-V CP who underwent a spinal fusion for scoliosis at a major quaternary-care children's hospital from January 2009 to October 2015 were reviewed and relevant data were abstracted. Descriptive statistics and regression models were used to compare patients.
    Results: Sixty-nine patients were included-19 ITB therapy and 50 no ITB therapy. Demographic and operative characteristics were similar across groups. The mean length of stay for patients in the ITB therapy group was 11.2 days and 14.3 days for the no ITB therapy group, with no difference between groups (p = .12). Pain scores in both groups decreased at the same rate, with scores in the ITB therapy group averaging one-half point lower (p = .32). The average amount of morphine equivalents (p = .71) and benzodiazepine equivalents (p = .53) used were similar between groups. Complication rates were significantly different between groups. Four (21%) of the ITB therapy patients had 1 or more complications whereas 28 (56%, p = .01) in the no ITB therapy group had 1 or more complications. The average number of complications per patient in the ITB therapy group was 0.3 (SD: 0.075, range: 0-3) and the no ITB therapy group was 1.1 (SD: 1.1, range: 0-6, p = .01).
    Conclusions: There was no significant difference in length of stay, pain scores, or pain/spasticity medication use between groups after spinal fusion, but there was a significantly lower incidence of complications in the ITB therapy group.
    MeSH term(s) Baclofen/therapeutic use ; Catheters, Indwelling ; Cerebral Palsy/physiopathology ; Female ; Humans ; Male ; Muscle Relaxants, Central/administration & dosage ; Muscle Spasticity/therapy ; Pain/etiology ; Postoperative Complications ; Retrospective Studies ; Scoliosis/surgery ; Spinal Fusion/adverse effects
    Chemical Substances Muscle Relaxants, Central ; Baclofen (H789N3FKE8)
    Language English
    Publishing date 2018-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632639-0
    ISSN 1542-538X ; 0744-6020
    ISSN (online) 1542-538X
    ISSN 0744-6020
    DOI 10.1097/NOR.0000000000000434
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Pediatric intrathecal baclofen management during the COVID-19 pandemic in the US and Canada.

    Thomas, Sruthi P / Hardesty, Christina K / Buxton, Kristin A / Collins, Andrew B / Pruente, Jessica / Pham, Kelly L D / Sheriko, Jordan / McClanahan, M Elise / Inanoglu, Didem / Srinivasan, Rajashree / Ridnour, Laura / Cooper, Robert / Khurana, Seema / Network, The Pediatric Itb

    Journal of pediatric rehabilitation medicine

    2020  Volume 13, Issue 3, Page(s) 379–384

    Abstract: The COVID-19 pandemic has been a challenge to healthcare systems around the world. Within pediatric rehabilitation medicine, management of intrathecal baclofen has been particularly challenging. This editorial reviews how programs in the US and Canada ... ...

    Abstract The COVID-19 pandemic has been a challenge to healthcare systems around the world. Within pediatric rehabilitation medicine, management of intrathecal baclofen has been particularly challenging. This editorial reviews how programs in the US and Canada coped with the quickly changing healthcare environment and how we can learn from this pandemic to be prepared for future crises.
    MeSH term(s) Baclofen/administration & dosage ; COVID-19/epidemiology ; Child ; Comorbidity ; Humans ; Injections, Spinal ; Muscle Relaxants, Central/administration & dosage ; Muscle Spasticity/drug therapy ; Muscle Spasticity/epidemiology ; Pandemics ; SARS-CoV-2 ; Treatment Outcome
    Chemical Substances Muscle Relaxants, Central ; Baclofen (H789N3FKE8)
    Keywords covid19
    Language English
    Publishing date 2020-10-30
    Publishing country Netherlands
    Document type Letter
    ZDB-ID 2403637-7
    ISSN 1875-8894 ; 1874-5393
    ISSN (online) 1875-8894
    ISSN 1874-5393
    DOI 10.3233/PRM-200755
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Pediatric intrathecal baclofen management during the COVID-19 pandemic in the US and Canad

    Thomas, Sruthi P / Hardesty, Christina K / Buxton, Kristin A / Collins, Andrew B / Pruente, Jessica / Pham, Kelly L D / Sheriko, Jordan / McClanahan, M Elise / Inanoglu, Didem / Srinivasa, Rajashree / Ridnour, Laura / Cooper, Robert / Khurana, Seema / Network, The Pediatric Itb

    Journal of pediatric rehabilitation medicine (Online)

    Abstract: The COVID-19 pandemic has been a challenge to healthcare systems around the world. Within pediatric rehabilitation medicine, management of intrathecal baclofen has been particularly challenging. This editorial reviews how programs in the US and Canada ... ...

    Abstract The COVID-19 pandemic has been a challenge to healthcare systems around the world. Within pediatric rehabilitation medicine, management of intrathecal baclofen has been particularly challenging. This editorial reviews how programs in the US and Canada coped with the quickly changing healthcare environment and how we can learn from this pandemic to be prepared for future crises.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #916436
    Database COVID19

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