Duarte Rui V, Raphael Jon H, Southall Jane L, Baker Candice, Ashford Robert L
Faculty of Health, Birmingham City University, Birmingham, United Kingdom.
Clin Neurol Neurosurg. 2012 Jul;114(6):577-84. doi: 10.1016/j.clineuro.2011.12.007. Epub 2011 Dec 26.
To investigate the existence of an association between formation of catheter tip intrathecal inflammatory masses with opioid dose and/or concentration.
A systematic review of catheter tip granulomas case reports and comparison with a control group was carried out. A boolean search was conducted in the electronic databases MEDLINE and EMBASE. The patients' data extracted from the case reports was tested for homogeneity with a control group. Subsequent analysis investigating the association of opioid dose, concentration and flow rate with the formation of catheter tip granulomas was performed.
Seventeen articles resulting in 24 patients with granulomata were included in the review. One patient in our department with granuloma formation was added to this group. Control group comprised 31 patients with an average follow-up of 68.3±9.7 months. The groups were homogeneous considering the variables age, gender and duration of pain previous to implant. Morphine dose (r=0.821, p<0.001) and concentration (r=0.650, p<0.001) were significantly correlated with the development of catheter tip intrathecal masses.
Opioid dose and concentration were significantly associated with the development of catheter tip granulomas. A correlation with opioid concentration was confirmed for the first time.
探讨鞘内导管尖端炎性肿块的形成与阿片类药物剂量和/或浓度之间是否存在关联。
对导管尖端肉芽肿病例报告进行系统回顾，并与对照组进行比较。在电子数据库MEDLINE和EMBASE中进行布尔检索。从病例报告中提取的患者数据与对照组进行同质性检验。随后进行分析，研究阿片类药物剂量、浓度和流速与导管尖端肉芽肿形成之间的关联。
该综述纳入了17篇文章，共24例患有肉芽肿的患者。我们科室有1例形成肉芽肿的患者被纳入该组。对照组包括31例患者，平均随访时间为68.3±9.7个月。考虑年龄、性别和植入前疼痛持续时间等变量，两组具有同质性。吗啡剂量（r=0.821，p<0.001）和浓度（r=0.650，p<0.001）与鞘内导管尖端肿块的发生显著相关。
阿片类药物剂量和浓度与导管尖端肉芽肿的发生显著相关。首次证实了与阿片类药物浓度的相关性。
