Intrathecal Pain Pump Implant: What To Expect
- NSPC Team
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.
A pain management specialist places the pain pump under the skin of your abdomen, right above the belt area. Other people cant see it, even if youre wearing a swimsuit. The pump is connected to a small tube 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 , 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 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.
How The Pain Ball Works
The pain ball pump is connected to a small catheter , which is inserted by your Summa Health orthopedic surgeon or anesthesiologist. Depending on your procedure, the catheter is placed near the surgical incision site or under the skin next to a nerve near the surgical area.
The pain ball pump continuously delivers the medication at a very slow flow rate. As the medication is released the pump gradually becomes smaller. However, it may take more than 24 hours after your procedure to notice a change in the pumps appearance. Depending on the pump size, it may take 2-5 days to release all the medication. Once all the medication is delivered, the outside bag becomes flat and a hard tube can be felt in the center of the pump.
Ask your Summa Health orthopedic surgeon and pain management team if the pain ball system is an appropriate treatment option for you, or call usat .
Living With An Intrathecal Pump
You must schedule medication refills on a regular basis with the surgeon or a pain management specialist. At your refill appointment, the effectiveness of your treatment will be assessed and your pump will be adjusted accordingly. The goal is to find the optimal amount of pain or spasticity control while having minimal side effects. You should tell your doctor if you experience unusual symptoms, drug overdose, or feel that your dosage is ineffective. You may need to take supplemental oral medicine if you have periods of stronger pain.
Just like a cardiac pacemaker, other devices such as cellular phones, pagers, microwaves, security doors, and anti theft sensors will not affect your pump. Be sure to carry your Implanted Device Identification card when flying, since the device is detected at airport security gates.
If you hear the pump making beeping sounds, call the doctors office immediately. This may indicate that the pump needs refilled, battery needs replaced, or other maintenance.
Withdrawal symptoms from the medication you are receiving may cause you some discomfort or in extreme cases may require emergency treatment. Inform family members and friends about what to do in an emergency always carry your Emergency Information and Procedure cards with you at all times.
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Pain Pump Removal Steps
What Happens Before Surgery
You may be scheduled for presurgical tests several days before surgery. In the doctors office you will fill out paperwork and sign consent forms. Patients are admitted to the hospital the morning of the procedure. No food or drink is permitted past midnight the night before surgery. An intravenous line is started in your arm. An anesthesiologist will explain the effects of anesthesia and its risks.
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Shoulder Pain Pump Side Effects Lawyers
If you or a loved one has suffered serious side effects or injuries after using a shoulder pain pump, you may be entitled to compensation for your injuries. Contact us today for a free and confidential pain pump lawsuit review.
Bernstein Liebhard is a nationally recognized law firm located in New York City that exclusively represents injured plaintiffs in a variety of individual and class actions nationwide. We have been ranked among the top plaintiffs law firms in the coutry by the National Law Journal for the past six yearsan honor achieved by only one other law firm in the the United States. Our experienced pain pump trial attorneys are standing by ready to review your case. We represent our injured clients on a contigency fee basis, meaning that we advance all costs and do not collect any attorneys fees unless we are successful.
What Is An Intrathecal Drug Pump
The fluid filled space around your spinal cord is called the subarachnoid or intrathecal space. Cerebrospinal fluid flows through this area, bathing and protecting your brain and spinal cord. An intrathecal drug pump works more efficiently than oral medication because it delivers medicine directly into the CSF, bypassing the path that oral medication takes through your body. In fact, you generally need about 1/300 the amount of medication with a pump than when taken orally.
The pump is a round metal device about the size of a hockey puck that is surgically implanted beneath the skin of your abdomen. A small plastic tube, called a catheter, is surgically placed in the intrathecal space of the spine and is connected to the pump . A space inside the pump called the reservoir holds the medication.
The pump is programmed to slowly release medication over a period of time. It can also be programmed to release different amounts of medication at different times of the day, depending on your changing needs. The pump stores the information about your prescription in its memory, and your doctor can easily review this information with the programmer. When the reservoir is empty, the doctor or nurse refills the pump by inserting a needle through your skin and into the fill port on top of the reservoir.
This therapy is completely reversible if you should ever decide to have the pump removed.
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What To Expect Once You Have A Pump
- Your doctor will work closely with you to get the medication dose just right.
- You will learn how to use the optional remote control, that allows you to get extra pain relief medicine, as needed.
- There are follow-up visits every 3-5 months, so your doctors office can refill your pump medications.
- Magnetic resonance imaging scans are allowed, while you have a pump.
- A majority of patients prefer to have a pump for the rest of their life. However, a pump can be removed if your painful condition improves to the point you no longer need treatment.
Local Anesthetic Infusion Pump Systems Adverse Events Reported To The Food And Drug Administration
S. Lori Brown, Audrey E. Morrison Local Anesthetic Infusion Pump Systems Adverse Events Reported to the Food and Drug Administration. Anesthesiology 2004 100:13051307 doi:
THE purpose of this report is to characterize adverse event reports on continuous direct local anesthetic infusion into surgical wounds using infusion pump systems devised for this purpose. These pump systems typically consist of disposable, nonelectrical pumps or electromechanical pumps that deliver a continuous infusion at controlled rates for a specified duration of time. Postoperative pain may be managed by continuous direct infusion of anesthetic into a surgical wound. This technique is reportedly used in a variety of surgeries, e.g. , inguinal hernia repair, upper abdominal surgery, laparoscopic nephrectomy, cholecystectomy, knee arthroplasty, and shoulder and gynecologic operative laparoscopy.
Infusion pump systems for anesthetic wound perfusion are regulated by the U.S. Food and Drug Administration as medical devices. The FDA monitors the performance of regulated medical devices via a passive surveillance system.
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Side Effects Requiring Immediate Medical Attention
Along with its needed effects, ropivacaine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking ropivacaine:
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- lightheadedness, dizziness, or fainting
- Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
- difficulty in passing urine
- Absence of or decrease in body movement
- bluish color of the skin or changes in skin color
- changes in vision
- continuing ringing or buzzing or other unexplained noise in the ears
- muscle spasms or twitching seizures
- muscle weakness
- pain or discomfort in the arms, jaw, back, or neck
- pain, redness, or swelling in the arm or leg
- problems with memory
- seeing or hearing things that are not there
- severe, unusual tiredness or weakness
- swelling of the foot or leg tenderness
- tightness in the chest
- inability to breathe without assistance
- paralysis of the arms
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
Intrathecal Opioid Pumps: Few Pros Many Cons
by Health Professional
An intrathecal opioid pump is really not something that you would wish for your BFF or your worst enemy. That special someone would have to be in a pretty dire situation in order to receive a pump. Once the pump is in place, that person is still probably in miserable pain just at a slightly lesser degree. However, now that person is dealing with the numerous problems associated with intrathecal pumps. Nope, these devices which inject chemicals directly into the spinal canal from a surgically implanted pump are fraught with enough complications that even a minor amount of benefit may not be worthwhile for anyone, friend or foe.
Becoming a candidate for an is not a race that anyone really wants to win. Only the very worst cases of extremely severe pain are considered. Prior to declaring pump candidacy, the individual considering this treatment option must have been through an entire gamete of oral and have failed miserably. Usually this individual has pain from a malignancy, but occasionally people with non-malignant pain are considered. Before the surgeon can implant a pump, each candidate must be fully informed about the numerous problems that could arise from the moment that pump is implanted underneath the skin all the way until the moment he/she is pushing up daisies or the device is permanently removed or deactivated.
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Pain Pumps Devices For Managing Chronic Pain
A pain pump, otherwise known as an intrathecal drug delivery pump, is a medical device that is used to directly deliver medication to the fluid-filled space around the spinal cord. The medication interrupts pain signals sent from the spine to the brain which eases the perception of pain.
What is a pain pump?
A pain pump is a small, round device that is surgically implanted under the fat of the abdomen. The pump is about the size of a hockey puck and administers medication to the spine via a small plastic tube known as a catheter. A pain pump comes with a reservoir that holds the medication. It can be programmed to slowly release medication throughout the day so an individual can rely on a steady supply of medication to reduce pain symptoms.
What are the benefits of pain pumps?
Pain pumps are a valuable treatment option if other conventional methods to reduce chronic pain have failed. As the medication is directly delivered to the area in need, pain is easier to control, and medication can be administered in smaller doses than oral medication. A pain pump is designed to reduce side effects of oral medications by reducing the amount of medication needed to control symptoms.
Pain pumps are easily monitored and refilled by a health care provider. The device stores an individuals prescription in its memory and is refilled through the insertion of a needle into the skin to fill the reservoir. Pain pumps are 100% reversible if an individual should ever need to have it removed.
Potential Problems While Wearing The Pain Pump
Sometimes medication leaks out of the small insertion site. If there is a significant amount of leakage, the wet dressing can be changed, just be careful not pull out the tubes.
Most of our patients do not have any issues with and are very thankful for the pain pump. Possible side effects are shortness of breath, headache, metal taste in your mouth, and/or blurred vision.
- If you experience shortness of breath, go to ER immediately and contact your doctor.
- If you have a headache or blurred vision, it might be a symptom of either the on-q pain medication or one of the other medications that you have been prescribed. Try to identify which medication is causing the problem and either call us or send us a message via the portal. Another possible minor side effect is a metal taste in your mouth. If you decide that the pain pump is the cause to any of these issues, but the issue is not bothering you too much, it is OK to leave the pain pump tubes in. If the issue is causing you too much discomfort, you can remove the pain pump at any time. The pain pump is to help make you comfortable.
If you have any questions, please give us a call or send us a portal message.
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Pain Pumps Linked To Cartilage Disorder Chondrolysis And Pagcl
A shoulder pain pump is a medical device with a catheter that is implanted into the shoulder during arthroscopic surgery to alleviate post-operative shoulder joint pain. Shoulder pain pumps work by infusing pain medication directly into the shoulder through the catheter continuously until post-operative pain subsides.
The link between shoulder pain pumps and PAGCL was only recently established through medical studies, including a study published in the October 2007 issue of The American Journal of Sports Medicine. According to the study, as much as 63 percent of patients who use shoulder pain pumps are at risk of developing PAGCL. Due to the high risk of PAGCL, the studys authors recommend that patients avoid using shoulder pain pumps, especially those that use bupivacaine with epinephrine, until their effects are further studied.
With PAGCL, hyaline cartilage in the shoulder joint is destroyed, leaving an individual with a limited range of motion and constant pain. Unfortunately, PAGCL treatments are merely palliative, meaning they merely treat PAGCL symptoms and do not cure the condition. Typically, pain medication and further shoulder surgery, including shoulder replacement surgery, are the only treatment options for PAGCL.
What Happens During Surgery
There are two parts to the procedure: 1) placement of the catheter in the intrathecal space surrounding the spinal cord, and 2) placement of the pump/reservoir in the abdomen. There are five main steps of the procedure. The operation generally takes 3 to 4 hours.
Step 1: prepare the patient You are placed on the operative table and given anesthesia. Once asleep, your body is rolled onto its side. Next, the areas of your back and stomach are shaved and prepped where the catheter and the pump are to be placed.
Step 2: placement of the catheter A small skin incision is made in the middle of your back. The bony arch of the vertebra is exposed. The catheter is placed in the subarachnoid, or intrathecal space, above the spinal cord and secured in place with sutures .
Step 3: tunneling of the extension Once the catheter is in place, an extension catheter is passed under the skin from the spine, around your torso to the abdomen where the pump will be implanted.
Step 4: placement of the pump A 4-6 inch skin incision is made in the side of your abdomen below the waistline. The surgeon creates a pocket for the pump between the skin and muscle layers. The extension catheter is attached to the pump. Next, the pump is correctly positioned under the skin and sutured to the thick fascia layer overlying the stomach muscles.
Step 5: close the incisions The incision in your back and abdomen are closed with sutures or staples and a dressing is applied.
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What Happens After Surgery
You will wake up in the postoperative recovery area, called the PACU. Your blood pressure, heart rate, and respiration will be monitored, and your pain will be addressed. Most patients are discharged home the same day. You will be given written instructions to follow when you go home.
On Q Pain Pump Lawyer
If you or a loved one has suffered post arthroscopic cartilage damage, chondrolysis, or other serious side effects or injuries after using the On Q Pump or any other pain pump, you can pursue a shoulder pain pump lawsuit and recover compensation for your injuries. Contact us today for a free and confidential case review.
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Link Between On Q Pump And Pacgl
The American Academy of Orthopedic Surgeons released a study in 2006 which described the link between pain pump use after arthroscopic shoulder surgery and the development of Postarthroscopic Glenohumeral Chondrolysis , a painful condition in which hyaline cartilage in the shoulder joint wears down.
In that study, twelve of 152 arthroscopic shoulder surgery patients examined in a three-year period developed PAGCL . The only factor that these 12 patients had in common was their treatment with a shoulder pain pump, such as the On Q Pump.
According to another study, which was published in the October 2007 issue of The American Journal of Sports Medicine, as much as 63 percent of patients who use shoulder pain pumps, like the On Q Pump, are at risk of developing PAGCL. Due to the high risk of PAGCL, this studys authors recommended that shoulder pain pumps, such as the On Q Pump, should not be used until their effects are further studied.