Intrathecal Pain Pump in Las Vegas

An intrathecal pain pump is a surgically implantable unit placed in the body to deliver pain medicine directly to the spinal cord. This device consists of a small pump positioned under the skin of the lower abdominal region. The battery-powered unit delivers medication to the spinal cord via a small catheter.

Who needs a intrathecal pump implant?

An intrathecal pump implant is used for people who have failed on other forms of pain management. You are a candidate for this pump if you:

  • Are dependent on pain medication.
  • Have failed on conservative therapies.
  • Have no serious medical conditions.
  • Are not a candidate for additional surgery.
  • Had a positive experience with the trial dose.

How is the intrathecal pump better than regular by-mouth medications?

Oral (by-mouth) medications must pass through the gastrointestinal tract. The purpose of the intrathecal pain pump is to manage the patient’s symptoms while eliminating unwanted side effects, such as nausea and vomiting. The pump delivers pain medicine directly into the cerebrospinal fluid, and it will bypass the gastrointestinal tract. The potency of the medication is around 200 times of that which can be taken by mouth.

How does the pump look?

The intrathecal pump is a round, small metal unit, which is surgically implanted in the lower abdomen. The catheter is a plastic tube that runs from the pump to the intrathecal space, which is a sac that surrounds the spinal cord. Holding the medication, the pump is a reservoir used to deliver medication to the targeted site.

How does the pump deliver the medication?

The intrathecal pump is programmed to gradually deliver medicine over a set period of time. Varying amounts of medicine is delivered throughout the day, and this can be modified to meet the patient’s needs. The pump has a small computer, so the doctor can review the use of medication and program the amount to be delivered.

What can I expect when the pump runs out of medicine?

A reservoir holds the medication as necessary. When this medicine is all gone, a nurse will refill the reservoir by inserting a needle through the skin to fill the device.

What occurs with the intrathecal pump trial?

Before permanently placing the intrathecal pump in the body, the doctor will use a trial to determine if or not the device will work for you. This involves a trial, which is done to determine if the device will eliminate or improve your pain. The trial involves giving a single dose of medicine by way of spinal injection, or offering several injections via a lumbar puncture or catheter. If the doctor chooses to do so, a full trial is done by placing a catheter near the spinal cord, and connecting it to an external pump.

What medications are used in the intrathecal pain pump?

Usually, an opioid does not relieve the discomfort associated with nociceptive pain disorders. For neuropathic pain syndromes, clonidine and/or local anesthetics can be added. Zicontide is an N-type calcium channel blocker found to improve refractory pain.

What side effects are associated with these medications?

Opioid agents, such as morphine, hydromorphone, and fentanyl, can lead to dizziness, respiratory depress, constipation, nausea, vomiting, itching, and urinary retention. Clonidine and calcium channel blockers can cause low blood pressure, dizziness, and headache.

What complications and risks occur with the intrathecal pain pump?

As with other minimally invasive procedures, there are some complications and risks associated with the pain pump. These include dislodging or blocking of the catheter, blood vessel damage, nerve injury, cerebrospinal fluid leak, and infection.

Resources

Bennett G, Burchiel K, Buchser E, Classen A, Deer T (2000). Clinical guidelines for intraspinal infusion: report of an expert panel. J Pain Symptom Manage, 20 (2;suppl):S37-S43.

Burton AW, Rajagopol A, Shah HN (2004). Epidural and intrathecal analgesia is effective in treating refractory cancer pain. Pain Medicine, 5(3):239-247.

Ferrante FM (1999). Neuraxial infusion in the management of cancer pain. Oncology, 13(5;suppl 2):30-36.

Prommer E (2006). Ziconotide: a new option for refractory pain. Drugs Today, 42(6):369-378.