Intrathecal Pain Pump Implant: What to Expect
An intrathecal pain pump is a small medical device, that delivers medications directly to the spinal cord, into the intrathecal space. Medications placed here, have a stronger and faster pain relief effect than medications taken in pill form. Show
A pain management specialist places the pain pump under the skin of your abdomen, right above the belt area. Other people can’t see it, even if you’re wearing a swimsuit. The pump is connected to a small tube (catheter) that drips medications directly around your spinal cord. The spinal cord is the “mecca” of pain sensations. Just like the brain, the spinal cord is very important in receiving pain signals from the rest of the body. It has many receptors (sensors), that can shut off the pain. Among these are the opioid receptors. Opioids are commonly used in pain pumps, sometimes in combination with other medications. When delivered through a pain pump, opioids have fewer systemic (body-wide) side effects. A pain pump is a great way to control long-lasting pain that has failed to improve with other treatments or with surgery. Who benefits from having a pump?Pain pumps, also known as implantable drug delivery systems, are often the last resort treatment for cancer pain and other chronic pain conditions. They are also used to relieve chronic muscle spasms in people with certain neurologic illnesses. A pump is recommended for people with:
Advantages of having a pain pumpReceiving medications through a pain pump, instead of taking them in pill form, has several advantages:
Is a pain pump the right choice for me?Your doctor may recommend a pain pump if you meet some of these criteria:
You are not a candidate for a pain pump if:
What medicine goes in the pump?Usually, your pump delivers different types of medications. They can sometimes be used together to enhance each other, in order to give you superior pain relief. Based on your response during a one week trial, your doctor will decide what works best for you. Medications used in your pump include:
The trialPain management doctors specialize in implanting pain pumps. Before implanting a pump, your doctor will first do a trial. During the trial you will receive a single shot of medication in your back, in the space that surrounds your spinal cord. This is a quick procedure, done in the doctor’s office. It is not very painful – it merely feels like a flu shot. You go home the same day. The trial allows your doctor to find the best type of drug for your pain. If your pain decreases by at least 50%, the trial is successful and you are then scheduled for a pump implant. The pump implantThe pump implant procedure usually takes 30 minutes to an hour. You are under general anesthesia, so you are completely comfortable and unaware of the procedure. You go home the same day. What are the dangers of a pain pump?Common ones include nausea, vomiting, pruritus, urinary retention, constipation, sexual dysfunction, and edema. Less common ones include respiratory depression, and hyperalgesia. Catheter tip inflammatory mass formation is a less common complication that may not be mediated by opioid receptors.
What is the success rate of a pain pump?Improvements in Pain, Physical Function, and Quality of Life
Overall, 94% (398/422) of patients reported improved pain control following pump implantation with 59% of patients stating their pump provides good to excellent pain relief (249/422).
What are complications of an intrathecal pump?Complications. Overdose. An overdose is usually the result of incorrect pump programming, pump failure, or, in the case of the Prometra pump, failure to empty the reservoir before MRI. ... . Withdrawal. ... . Cerebrospinal fluid leak. ... . Management of CSF leak. ... . Granuloma formation. ... . Obstruction of CSF flow. ... . Infection.. How long can you have a pain pump?The device can stay there as long as you need it. Your doctor can refill the pump with more medicine. The device is sometimes called an intrathecal pain pump.
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