Gatscher S, Becker R, Uhle E, Bertalanffy H
Department of Neurosurgery, Philipps-University Hospital, Marburg, Germany.
Acta Neurochir Suppl. 2002;79:75-6. doi: 10.1007/978-3-7091-6105-0_16.
Complex pain syndromes due to spasticity and central deafferentation often fail to respond to medical therapy and create challenging problems in the pain management. So far, only spasticity associated musculosceletal pain has been reported to respond to intrathecal baclofen application [1, 2].
We report the treatment of severe neuropathic pain in a patient with ED and the combined intrathecal application of baclofen and morphine in 5 patients with severe spasticity related pain.
Continuous intrathecal baclofen infusion resulted in a pain free period of 20 months in the patient with ED. Patients with spasticity treated with intrathecal application of baclofen and morphine were pain free for a mean period of 2 years.
Intrathecal baclofen and morphine application proved to be effective in spasticity related and central deafferentation pain and should therefore be considered in the management of these patients.
由痉挛和中枢性传入神经阻滞引起的复杂性疼痛综合征通常对药物治疗无反应，并在疼痛管理中产生具有挑战性的问题。到目前为止，仅有与痉挛相关的肌肉骨骼疼痛被报道对鞘内注射巴氯芬有反应[1,2]。
我们报告了1例患有勃起功能障碍（ED）患者的严重神经性疼痛的治疗情况，以及5例患有严重痉挛相关疼痛患者鞘内联合应用巴氯芬和吗啡的情况。
持续鞘内输注巴氯芬使ED患者有20个月的无痛期。鞘内应用巴氯芬和吗啡治疗的痉挛患者平均有2年的无痛期。
鞘内应用巴氯芬和吗啡被证明对痉挛相关和中枢性传入神经阻滞性疼痛有效，因此在这些患者的管理中应予以考虑。
