The treatment of tetanus with intrathecal baclofen

The treatment of severe tetanus generally requires prolonged mechanical ven tilation. We describe two cases managed with continuous intrathecal infusio n of baclofen via a subcutaneous tunnelled spinal catheter and an abdominal injection port. Baclofen, by diminishing spasms and spasticity, allowed re duced sedation and paralysis requirements. This potentially decreases the t ime and resources required for intensive care management. Complications inc lude sedation, hypotension and CSF infection. After appropriate dose adjust ment, baclofen improves the management of severe tetanus.