Targeted drug delivery System for pain management

What Is an Intrathecal Drug Pain Pump?

An Intrathecal Drug Pain Pump (also referred to as a Pain Pump, Intrathecal Pump, or Targeted Drug Delivery/TDD) is a medical device that is fully implanted in the patient’s body and delivers medication. The medication is stored in a reservoir inside the pump and is delivered continuously though a small tube, called a catheter, into the fluid around the spinal cord (the intrathecal space). The pump is about the size of a hockey puck and the catheter the size of a strand of angel hair pasta.

The pump typically holds one to three months of medication and is refilled using a small needle accessing the medication reservoir. Refilling the pump is relatively painless and takes about five minutes.

This device allows the patient to use a much smaller, targeted dose of medication, which may lessen the side effects and improve pain control. At CPSC, our providers practice personalized medicine and the medication in the pump is custom ordered for each patient and their specific pain and tolerance.

Advantages Of Intrathecal Drug Delivery

Smaller doses

A pain pump allows targeted drug delivery to the spinal cord while bypassing the barriers encountered by oral medications (e.g. gastrointestinal track, blood stream, and blood-brain barrier).

Fewer side effects

Targeted drug delivery gives you pain relief with a fraction of the amount of medicine and less side effects compared to oral medications. The decreased doses reduce side effects while the therapy optimizes pain control.

Improved pain relief

Targeted drug delivery has shown to be more effective in managing pain than conventional medical management with less medicine.

Increased survival rate

Cancer pain can cause people to stop treatment which lowers survival rates. By managing pain this allows patients to maintain treatments improving survival rates.

Who is a good candidate for a pain pump?

Pain Pump Options

There are currently two pump manufacturers, Medtronic and Flowonix. While both pumps are both programmable and each has its own patient-controlled bolus device, the mechanics of each pump differ. There are some specific advantages to each of the pumps, please ask your provider for more details.

Pain pumps are programmed using a tablet and Bluetooth connection. In most cases your doctor will set a continuous rate, equivalent to a long-acting (or sustained-release) pain pill, and a bolus dose, equivalent to your breakthrough (or short-acting) pain pill. You will be able to give yourself extra doses as needed using a PTM (patient therapy manager) or PTC (patient therapy controller) depicted above.

Process for getting an intrathecal pain pump

After you and your provider determine you are a candidate for TDD, you will first complete a Behavioral Health Evaluation. The goal of this assessment is to confirm you understand the therapy and that your expectations for the therapy is consistent with your healthcare provider’s expectations. As every patient and every patient’s pain is different, your CPSC providers will custom order your medications for your pump. If you pain relief is not adequate or side effects are intolerable, a new combination and/or concentrations of medications may be ordered. To achieve maximum pain relief and minimal side effects, we encourage you to communicate with your providers and our staff.

Before Surgery

The Trial

Candidates for pain pumps will first be scheduled for a trial to assess the effectiveness of the therapy. There are two different types of trials: a Single-Shot Injection or a Continuous Intrathecal Infusion. Following a successful trial, in which your pain is reduced by at least 50%, you will be scheduled for a Pre-Operative Visit.

During Surgery

The Pump Implant

The pump is usually surgically implanted in the lower abdomen and the catheter is inserted into your lower back. One end of the catheter is connected to the pump and the other is positioned in your spinal fluid. The pump is implanted with medication and will begin infusing immediately after implant.

Follow up

Post Surgery

You may experience pain relief within a few hours after surgery, or you may require an adjustment to your dose when your provider feels it is appropriate. You will return to the clinic around 7 days following your implant for a Post-Surgical Evaluation. We will assess your incisions and discuss any changes to your dose or medications that might be necessary.

A day in pain is a day lost
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