Intrathecal

Intrathecal is an adjetive that refers to something that happens inside of the spinal canal. For example, intrathecal immunoglobulin production means production of this substance in the spinal cord [Meinl E, Krumbholz M, Derfuss T, Junker A, Hohlfeld R. Compartmentalization of inflammation in the CNS: A major mechanism driving progressive multiple sclerosis, J Neurol Sci. 2008 Aug 18, PMID 18715571] ..

As other example, an intrathecal injection (often simply called "intrathecal") is an injection into the spinal canal (intrathecal space surrounding the spinal cord), as in a spinal anaesthesia or in chemotherapy or pain management applications. This route is also used for some infections, particularly post-neurosurgical. The drug needs to be given this way to avoid the blood brain barrier. The same drug given orally must enter the blood stream and has a much harder time reaching the brain; by the time it does, most of the drug has been absorbed by the body's system and is excreted. Drugs given intrathecally often have to be made up specially by a pharmacist or technician because they cannot contain any preservative or other potentially harmful inactive ingredients that are sometimes found in standard injectable drug preparations.

Intrathecal administration of analgesia:

*Popular for a single 24-hour dose of analgesia (opioid with Local anesthetic)
*Caution because of late onset respiratory depression
*Severe pruritus and urinary retention may limit the use of intrathecal morphine
*Pethidine has the unusual properties of being both a local anaesthetic and opioid analgesic which occasionally permits its use as the sole intrathecal anaesthetic agent.

Intrathecal chemotherapy

*Currently, only three agents are licensed for intrathecal chemotherapy
*They are methotrexate, cytarabine (a.k.a. Ara-C) and hydrocortisone
*Administration of other chemotherapeutic agents with the intrathecal route could lead to fatal outcomes.

Intrathecal Baclofen

Often reserved for spastic cerebral palsy, intrathecally-administered baclofen is done through a intrathecal pump implanted just below the skin of the stomach with a tube connected directly to the base of the spine, where it bathes the appropriate nerves using a dose about one thousand times smaller than that required by orally-administered baclofen. Intrathecal baclofen also carries none of the side effects, such as sleepiness, that typically occur with oral baclofen. It is the preferred route for long-term management of spasticity in people with CP for whom other procedures, such as rhizotomy or orthopedic surgery, are inappropriate.

References

ee also

* Subarachnoid