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Malfunctioning sufentanil intrathecal pain pump: a case report

BACKGROUND: Sufentanil is a potent opioid uncommonly used to manage pain and is rarely administered via an intrathecal pain pump system. CASE PRESENTATION: This case illustrates the use of intrathecal sufentanil in a 50-year-old Caucasian man for the management of chronic pain; however, the intrathe...

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Autores principales: Warner, Lindsay, Branstad, Anna, Hunter Guevara, Lindsay, Matzke Bitterman, Laura, Pingree, Matthew, Nicholson, Wayne, Eldrige, Jason
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942373/
https://www.ncbi.nlm.nih.gov/pubmed/31900197
http://dx.doi.org/10.1186/s13256-019-2314-2
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author Warner, Lindsay
Branstad, Anna
Hunter Guevara, Lindsay
Matzke Bitterman, Laura
Pingree, Matthew
Nicholson, Wayne
Eldrige, Jason
author_facet Warner, Lindsay
Branstad, Anna
Hunter Guevara, Lindsay
Matzke Bitterman, Laura
Pingree, Matthew
Nicholson, Wayne
Eldrige, Jason
author_sort Warner, Lindsay
collection PubMed
description BACKGROUND: Sufentanil is a potent opioid uncommonly used to manage pain and is rarely administered via an intrathecal pain pump system. CASE PRESENTATION: This case illustrates the use of intrathecal sufentanil in a 50-year-old Caucasian man for the management of chronic pain; however, the intrathecal drug delivery system experienced a malfunction which led to 1/100th output of the correct dosage. Interesting aspects of this case report include the uncommon choice of sufentanil use for an intrathecal drug delivery system, as well as the unusual pharmacokinetics of this drug. Specifically, this patient did not experience the major withdrawal that would be expected given significant under dosing of opioid, and this may be explained by the lipophilicity and context-sensitive half-times of sufentanil. CONCLUSIONS: Because of the absence of a clinically significant withdrawal in this case report, clinicians must be aware of relevant pharmacokinetic properties and unusual intrathecal drug delivery system technologies that influence a patient’s response when device malfunction occurs.
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spelling pubmed-69423732020-01-07 Malfunctioning sufentanil intrathecal pain pump: a case report Warner, Lindsay Branstad, Anna Hunter Guevara, Lindsay Matzke Bitterman, Laura Pingree, Matthew Nicholson, Wayne Eldrige, Jason J Med Case Rep Case Report BACKGROUND: Sufentanil is a potent opioid uncommonly used to manage pain and is rarely administered via an intrathecal pain pump system. CASE PRESENTATION: This case illustrates the use of intrathecal sufentanil in a 50-year-old Caucasian man for the management of chronic pain; however, the intrathecal drug delivery system experienced a malfunction which led to 1/100th output of the correct dosage. Interesting aspects of this case report include the uncommon choice of sufentanil use for an intrathecal drug delivery system, as well as the unusual pharmacokinetics of this drug. Specifically, this patient did not experience the major withdrawal that would be expected given significant under dosing of opioid, and this may be explained by the lipophilicity and context-sensitive half-times of sufentanil. CONCLUSIONS: Because of the absence of a clinically significant withdrawal in this case report, clinicians must be aware of relevant pharmacokinetic properties and unusual intrathecal drug delivery system technologies that influence a patient’s response when device malfunction occurs. BioMed Central 2020-01-03 /pmc/articles/PMC6942373/ /pubmed/31900197 http://dx.doi.org/10.1186/s13256-019-2314-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Warner, Lindsay
Branstad, Anna
Hunter Guevara, Lindsay
Matzke Bitterman, Laura
Pingree, Matthew
Nicholson, Wayne
Eldrige, Jason
Malfunctioning sufentanil intrathecal pain pump: a case report
title Malfunctioning sufentanil intrathecal pain pump: a case report
title_full Malfunctioning sufentanil intrathecal pain pump: a case report
title_fullStr Malfunctioning sufentanil intrathecal pain pump: a case report
title_full_unstemmed Malfunctioning sufentanil intrathecal pain pump: a case report
title_short Malfunctioning sufentanil intrathecal pain pump: a case report
title_sort malfunctioning sufentanil intrathecal pain pump: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942373/
https://www.ncbi.nlm.nih.gov/pubmed/31900197
http://dx.doi.org/10.1186/s13256-019-2314-2
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