TITLE:
Pain and Perioperative Management: Awareness in Intrathecal Baclofen Pump Care
AUTHORS:
Harry McGrath, Fiona Griffin, Ronan MacManus, Dominic Harmon
KEYWORDS:
Intrathecal Baclofen, Perioperative Management, Baclofen Withdrawal, Spasticity, Medical Education, Knowledge Assessment, Patient Safety
JOURNAL NAME:
Pain Studies and Treatment,
Vol.14 No.3,
June
12,
2026
ABSTRACT: Background: Intrathecal baclofen (ITB) pumps are increasingly used for the management of severe spasticity across a range of neurological conditions. Interruption of ITB delivery can precipitate a life-threatening withdrawal syndrome with a reported case-fatality rate of up to 22% in FDA-reported episodes. Despite this, there is no published evidence evaluating perioperative clinical staff knowledge of ITB pumps, and no standardised training pathway exists at most institutions. Objectives: To assess baseline knowledge and confidence among non-specialist clinical staff regarding intrathecal baclofen pump identification, perioperative management, and complication recognition; to deliver a targeted teaching intervention; and to evaluate the impact of that intervention using a validated pre/post survey design. Methods: A prospective pre/post intervention study was conducted at a single institution. Anonymous questionnaire surveys were administered to 41 clinical staff (interns, SHOs, registrars, and SpRs) immediately before and after a structured teaching session on the perioperative management of ITB pumps. Outcomes assessed included awareness, confidence, knowledge retention, specialist referral awareness, and teaching session evaluation. Results: Pre-education, only 31.7% of participants were aware that ITB delivery interruption can cause life-threatening withdrawal. Confidence in perioperative management was critically low, with 73.2% reporting they were not confident and 0% very confident. Following the teaching session, 100% of participants achieved confident or very confident ratings in both preoperative identification (56.1% very confident) and perioperative management (87.8% very confident). All 41 participants (100%) correctly identified baclofen withdrawal on a knowledge test, and 100% knew who to contact for specialist advice. 92.7% reported the session improved their perioperative awareness, and 100% rated it as useful or very useful. Conclusions: This study identifies a significant and previously unquantified knowledge gap regarding the perioperative management of intrathecal baclofen pumps among non-specialist clinical staff. A single targeted teaching session produced uniform, dramatic improvements in knowledge, confidence, and specialist referral awareness across all training grades. These findings strongly support the integration of ITB pump perioperative management into formal training curricula and the development of institutional guidelines.