Intrathecal granuloma formation as result of opioid delivery: Systematic literature review of case reports and analysis against a control group

Duarte, R.V. and Raphael, J.H. and Southall, J.L. and Baker, Candice and Ashford, Robert L. (2012) Intrathecal granuloma formation as result of opioid delivery: Systematic literature review of case reports and analysis against a control group. Clinical Neurology and Neurosurgery, 114 (6). pp. 577-584. ISSN 03038467 (ISSN)

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Objective: To investigate the existence of an association between formation of catheter tip intrathecal inflammatory masses with opioid dose and/or concentration. Methods: A systematic review of catheter tip granulomas case reports and comparison with a control group was carried out. A boolean search was conducted in the electronic databases MEDLINE and EMBASE. The patients' data extracted from the case reports was tested for homogeneity with a control group. Subsequent analysis investigating the association of opioid dose, concentration and flow rate with the formation of catheter tip granulomas was performed. Results: Seventeen articles resulting in 24 patients with granulomata were included in the review. One patient in our department with granuloma formation was added to this group. Control group comprised 31 patients with an average follow-up of 68.3 ± 9.7 months. The groups were homogeneous considering the variables age, gender and duration of pain previous to implant. Morphine dose (r = 0.821, p < 0.001) and concentration (r = 0.650, p < 0.001) were significantly correlated with the development of catheter tip intrathecal masses. Conclusion: Opioid dose and concentration were significantly associated with the development of catheter tip granulomas. A correlation with opioid concentration was confirmed for the first time. © 2011 Elsevier B.V. All rights reserved.

Item Type: Article
Identification Number:
July 2012Published
Uncontrolled Keywords: Catheter tip granuloma, Intrathecal drug delivery systems, Opioid concentration, Opioid dose, Systematic review, bupivacaine, clonidine, morphine, adult, aged, catheterization, clinical article, controlled study, correlation analysis, data extraction, Embase, female, follow up, granuloma, human, implant, male, Medline, pain parameters, review, systematic review (topic), Adrenergic alpha-Agonists, Adult, Aged, Analgesics, Opioid, Bupivacaine, Catheters, Catheters, Indwelling, Clonidine, Data Interpretation, Statistical, Female, Granuloma, Humans, Infusion Pumps, Implantable, Injections, Spinal, Male, Middle Aged, Morphine, Risk, Spinal Cord Diseases
Subjects: CAH02 - subjects allied to medicine > CAH02-05 - medical sciences > CAH02-05-04 - anatomy, physiology and pathology
CAH02 - subjects allied to medicine > CAH02-02 - pharmacology, toxicology and pharmacy > CAH02-02-01 - pharmacology
Divisions: Faculty of Health, Education and Life Sciences > School of Nursing and Midwifery
Depositing User: Hussen Farooq
Date Deposited: 25 Feb 2017 09:01
Last Modified: 12 Jan 2022 11:19

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