Article

OBJECTIVE: To assess the impact of intrathecal baclofen (ITB) mode of
administration on sleep and sleep-related breathing events in severely disabled
patients with severe spasticity. DESIGN: Open prospective trial. SETTING: Physical medicine and rehabilitation department. PARTICIPANTS: Patients (N=11)
treated with ITB pump for severe spasticity. INTERVENTION: Assessment of
patients' sleep before and after ITB pump implantation, and comparison of
polysomnography results after continuous or bolus mode of administration of ITB.
MAIN OUTCOME MEASURES: Polysomnography and sleep-related breathing events.
RESULTS: ITB reduced periodic limb movements and increased the respiratory
disturbance index (RDI) and central apneas in our population of patients. This
study showed that ITB mode of administration may affect sleep-disordered
breathing. Indeed, we observed a significant increase of respiratory events in
the bolus condition (RDI and central apneas). In contrast, continuous infusion
did not induce a significant modification of sleep-disordered breathing. When a
sleep apnea syndrome was preexisting, it was generally severely worsened by the
bolus mode of administration. CONCLUSIONS:
These results indicate that sleep
function and sleep-related respiratory events should be assessed before ITB pump
implantation. It is probably better to use a continuous mode of infusion if
patients have preexisting sleep-disordered breathing.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS