In this section
Note: This guideline is currently under review.
Definition of terms
Assessment pre pump implantation
Baclofen is a GABA ß-agonist and is thought to diminish spasticity primarily by acting at a spinal cord level. It has muscle relaxing properties and is administered to reduce spasticity or dystonia. Patient groups receiving Intrathecal Baclofen (ITB) may include:
Baclofen can be administered orally or intrathecally. Intrathecal baclofen (ITB) has a much greater effect with significantly reduced doses as opposed to oral baclofen that crosses the blood brain barrier poorly. Long term intrathecal baclofen therapy is administered via a surgically implanted programmable pump that continuously infuses baclofen into the intrathecal space. Patients on ITB have reported reduced pain associated with spasticity, improved positioning, speech, quality of sleep and quality of life. The ITB pump is programmed by the Developmental Medicine Consultant or Rehabilitation Consultant (depending on patient's primary managing team)using an external device that communicates with the pump via telemetry.
The aim of the guideline is to outline the management of the implantation of an ITB pump, and ongoing care for patients requiring ITB therapy for all clinicians at RCH.
After hours call Developmental Medicine Consultant on-call. If the Developmental consultant requires support in regards to ITB troubleshooting after hours the on-call Rehabilitation Consultants is to be contacted
The device is designed to 'beep'if there is something wrong with the pump. If 'beeping' from a patient can be heard page the Developmental Medicine Consultant or Rehabilitation Consultant (depending on patient's primary managing team) urgently, to avoid serious clinical complications.
An empty pump may malfunction , it may then need to be surgically removed and replaced. It is important that suspected pump problems are addressed as a matter of urgency.
Obtain and document a thorough patient history and baseline observations including:
nursing assessment nursing guideline
Overdose may occur when:
appear insidiously or suddenly.
When support for Medtronic Neuromodulation products is required, please follow the instructions below:
Please note: Medtronic Neuromodulation does not provide a 24 hour support service in Australia
Intrathecal Baclofen Evidence Table
Please remember to
read the disclaimer.
The development of this nursing guideline was coordinated by Sacha Petersen, Clinical Nurse Consultant, Neurodevelopment and Disability, and approved by the Nursing Clinical Effectiveness Committee. Updated February 2019.