Leg edema from intrathecal opiate infusions.
Identifieur interne : 004936 ( PubMed/Corpus ); précédent : 004935; suivant : 004937Leg edema from intrathecal opiate infusions.
Auteurs : J A Aldrete ; Couto da Silva JMSource :
- European journal of pain (London, England) [ 1090-3801 ] ; 2000.
English descriptors
- KwdEn :
- Arachnoiditis (drug therapy), Causality, Chronic Disease, Comorbidity, Edema (chemically induced), Edema (diagnosis), Edema (epidemiology), Foot (pathology), Hyperpigmentation (chemically induced), Hyperpigmentation (diagnosis), Hyperpigmentation (epidemiology), Incidence, Infusion Pumps, Implantable, Injections, Spinal, Leg (pathology), Lymphedema (diagnosis), Morphine (administration & dosage), Morphine (adverse effects), Morphine (contraindications), Narcotics (administration & dosage), Narcotics (adverse effects), Narcotics (contraindications), Oxymorphone (administration & dosage), Oxymorphone (adverse effects), Oxymorphone (contraindications), Pseudarthrosis (drug therapy), Retrospective Studies, Skin (pathology), Venous Insufficiency (diagnosis).
- MESH :
- chemical , administration & dosage : Morphine, Narcotics, Oxymorphone.
- chemical , adverse effects : Morphine, Narcotics, Oxymorphone.
- chemically induced : Edema, Hyperpigmentation.
- chemical , contraindications : Morphine, Narcotics, Oxymorphone.
- diagnosis : Edema, Hyperpigmentation, Lymphedema, Venous Insufficiency.
- drug therapy : Arachnoiditis, Pseudarthrosis.
- epidemiology : Edema, Hyperpigmentation.
- pathology : Foot, Leg, Skin.
- Causality, Chronic Disease, Comorbidity, Incidence, Infusion Pumps, Implantable, Injections, Spinal, Retrospective Studies.
Abstract
Despite the increasing popularity of intrathecal infusions to treat patients with long-term non-cancer-related pain, this therapy is not without serious side-effects. Five out of 23 patients who had intrathecal infusions of opiates for longer than 24 months developed leg and feet edema. As predisposing factors, cardiovascular disease, deep venous thrombosis, peripheral vascular disease, and venous stasis of the lower extremities were considered. Every patient who developed pedal and leg edema after the implantation of an infusion pump was also found to have leg edema and venous stasis prior to the time when the pump was inserted. This complication was severe enough to limit their physical activity, and to produce lymphedema, ulcerations and hyperpigmentation of the skin. Reduction of the edema occurred when the dose of the opiate was decreased, and in two cases in which the infusion was discontinued, there was almost complete resolution of the syndrome. It appears that the pre-existence of pedal edema and of venous stasis is a relative contraindication to the long-term intrathecal infusion of opiates in patients with chronic non-cancer pain.
DOI: 10.1053/eujp.2000.0199
PubMed: 11124008
Links to Exploration step
pubmed:11124008Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Leg edema from intrathecal opiate infusions.</title><author><name sortKey="Aldrete, J A" sort="Aldrete, J A" uniqKey="Aldrete J" first="J A" last="Aldrete">J A Aldrete</name><affiliation><nlm:affiliation>Department of Anesthesiology, University of South Florida School of Medicine, Tampa, Florida, USA. taldrete@arachnoiditis.com</nlm:affiliation></affiliation></author><author><name sortKey="Couto Da Silva Jm" sort="Couto Da Silva Jm" uniqKey="Couto Da Silva Jm" last="Couto Da Silva Jm">Couto da Silva JM</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2000">2000</date><idno type="RBID">pubmed:11124008</idno><idno type="pmid">11124008</idno><idno type="doi">10.1053/eujp.2000.0199</idno><idno type="wicri:Area/PubMed/Corpus">004936</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">004936</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Leg edema from intrathecal opiate infusions.</title><author><name sortKey="Aldrete, J A" sort="Aldrete, J A" uniqKey="Aldrete J" first="J A" last="Aldrete">J A Aldrete</name><affiliation><nlm:affiliation>Department of Anesthesiology, University of South Florida School of Medicine, Tampa, Florida, USA. taldrete@arachnoiditis.com</nlm:affiliation></affiliation></author><author><name sortKey="Couto Da Silva Jm" sort="Couto Da Silva Jm" uniqKey="Couto Da Silva Jm" last="Couto Da Silva Jm">Couto da Silva JM</name></author></analytic><series><title level="j">European journal of pain (London, England)</title><idno type="ISSN">1090-3801</idno><imprint><date when="2000" type="published">2000</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arachnoiditis (drug therapy)</term><term>Causality</term><term>Chronic Disease</term><term>Comorbidity</term><term>Edema (chemically induced)</term><term>Edema (diagnosis)</term><term>Edema (epidemiology)</term><term>Foot (pathology)</term><term>Hyperpigmentation (chemically induced)</term><term>Hyperpigmentation (diagnosis)</term><term>Hyperpigmentation (epidemiology)</term><term>Incidence</term><term>Infusion Pumps, Implantable</term><term>Injections, Spinal</term><term>Leg (pathology)</term><term>Lymphedema (diagnosis)</term><term>Morphine (administration & dosage)</term><term>Morphine (adverse effects)</term><term>Morphine (contraindications)</term><term>Narcotics (administration & dosage)</term><term>Narcotics (adverse effects)</term><term>Narcotics (contraindications)</term><term>Oxymorphone (administration & dosage)</term><term>Oxymorphone (adverse effects)</term><term>Oxymorphone (contraindications)</term><term>Pseudarthrosis (drug therapy)</term><term>Retrospective Studies</term><term>Skin (pathology)</term><term>Venous Insufficiency (diagnosis)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Morphine</term><term>Narcotics</term><term>Oxymorphone</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Morphine</term><term>Narcotics</term><term>Oxymorphone</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Edema</term><term>Hyperpigmentation</term></keywords><keywords scheme="MESH" type="chemical" qualifier="contraindications" xml:lang="en"><term>Morphine</term><term>Narcotics</term><term>Oxymorphone</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Edema</term><term>Hyperpigmentation</term><term>Lymphedema</term><term>Venous Insufficiency</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Arachnoiditis</term><term>Pseudarthrosis</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Edema</term><term>Hyperpigmentation</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Foot</term><term>Leg</term><term>Skin</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Causality</term><term>Chronic Disease</term><term>Comorbidity</term><term>Incidence</term><term>Infusion Pumps, Implantable</term><term>Injections, Spinal</term><term>Retrospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Despite the increasing popularity of intrathecal infusions to treat patients with long-term non-cancer-related pain, this therapy is not without serious side-effects. Five out of 23 patients who had intrathecal infusions of opiates for longer than 24 months developed leg and feet edema. As predisposing factors, cardiovascular disease, deep venous thrombosis, peripheral vascular disease, and venous stasis of the lower extremities were considered. Every patient who developed pedal and leg edema after the implantation of an infusion pump was also found to have leg edema and venous stasis prior to the time when the pump was inserted. This complication was severe enough to limit their physical activity, and to produce lymphedema, ulcerations and hyperpigmentation of the skin. Reduction of the edema occurred when the dose of the opiate was decreased, and in two cases in which the infusion was discontinued, there was almost complete resolution of the syndrome. It appears that the pre-existence of pedal edema and of venous stasis is a relative contraindication to the long-term intrathecal infusion of opiates in patients with chronic non-cancer pain.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">11124008</PMID><DateCreated><Year>2001</Year><Month>01</Month><Day>26</Day></DateCreated><DateCompleted><Year>2001</Year><Month>03</Month><Day>01</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1090-3801</ISSN><JournalIssue CitedMedium="Print"><Volume>4</Volume><Issue>4</Issue><PubDate><Year>2000</Year></PubDate></JournalIssue><Title>European journal of pain (London, England)</Title><ISOAbbreviation>Eur J Pain</ISOAbbreviation></Journal><ArticleTitle>Leg edema from intrathecal opiate infusions.</ArticleTitle><Pagination><MedlinePgn>361-5</MedlinePgn></Pagination><Abstract><AbstractText>Despite the increasing popularity of intrathecal infusions to treat patients with long-term non-cancer-related pain, this therapy is not without serious side-effects. Five out of 23 patients who had intrathecal infusions of opiates for longer than 24 months developed leg and feet edema. As predisposing factors, cardiovascular disease, deep venous thrombosis, peripheral vascular disease, and venous stasis of the lower extremities were considered. Every patient who developed pedal and leg edema after the implantation of an infusion pump was also found to have leg edema and venous stasis prior to the time when the pump was inserted. This complication was severe enough to limit their physical activity, and to produce lymphedema, ulcerations and hyperpigmentation of the skin. Reduction of the edema occurred when the dose of the opiate was decreased, and in two cases in which the infusion was discontinued, there was almost complete resolution of the syndrome. It appears that the pre-existence of pedal edema and of venous stasis is a relative contraindication to the long-term intrathecal infusion of opiates in patients with chronic non-cancer pain.</AbstractText><CopyrightInformation>Copyright 2000 European Federation of Chapters of the International Association for the Study of Pain.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Aldrete</LastName><ForeName>J A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, University of South Florida School of Medicine, Tampa, Florida, USA. taldrete@arachnoiditis.com</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Couto da Silva JM</LastName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur J Pain</MedlineTA><NlmUniqueID>9801774</NlmUniqueID><ISSNLinking>1090-3801</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D009294">Narcotics</NameOfSubstance></Chemical><Chemical><RegistryNumber>76I7G6D29C</RegistryNumber><NameOfSubstance UI="D009020">Morphine</NameOfSubstance></Chemical><Chemical><RegistryNumber>9VXA968E0C</RegistryNumber><NameOfSubstance UI="D010111">Oxymorphone</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001100" MajorTopicYN="N">Arachnoiditis</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015984" MajorTopicYN="N">Causality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002908" MajorTopicYN="N">Chronic Disease</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015897" 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