INTRATHECAL CLONIDINE FOR REFRACTORY DETRUSOR HYPERREFLEXIA IN SPINAL-CORD INJURED PATIENTS - A PRELIMINARY-REPORT

Purpose: We assessed the urodynamic effect of various doses of intrath ecal clonidine on refractory detrusor hyperreflexia in spinal cord inj ured patients. Materials and Methods: Doses of 15, 30 or 45 mu g. intr athecal clonidine or placebo were given to 5 chronic complete spinal c ord injured patients with detrusor hyperreflexia. Two cystometries wer e performed before and 5, 30, 60, 90, 120 and 180 minutes after each i njection. Results: A statistically significant dose dependent decrease in detrusor hyperreflexia was observed in each patient without signif icant side effect. Conclusions: Intrathecal clonidine may represent a conservative reversible treatment for detrusor hyperreflexia via a sub cutaneous programmable pump, like that used for baclofen, for spastici ty. The long-term efficacy needs to be evaluated.