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PAIN MEDICINE

Dissociative Mental State in a Patient with an Intrathecal Drug Administration System

John P.R. Loughrey, MB MRCPI, FCARCSI, and Srdjan S. Nedeljkovi, MD

Department of Anesthesia, Pain, and Perioperative Medicine, Harvard Medical School, Brigham & Women’s Hospital, Boston, Massachusetts

Address correspondence and reprint requests to John Loughrey, MB, MRCPI, FCARCSI, Department of Anesthesia, Pain, and Perioperative Medicine, Harvard Medical School, Brigham and Women’s Hospital, 75 Francis St., Boston, MA 02115. Address e-mail to jloughrey{at}partners.org

IMPLICATIONS: We describe a patient with acute mental status changes, which resolved on removal of medication from the reservoir of a Synchromed^® intrathecal pump. This report highlights the potential adverse mental affects of chronic spinal infusions for pain therapy and discusses pitfalls in toxicology analysis using immunoassay.