The pump is filled with the drug morphine and is programmed by a computer to continuously release a specified dose that is determined by the physician. The operation is completed when the incision is closed with suture material stitches or surgical staples. If the outer incision is closed with staples or non-absorbable sutures, they will have to be removed after the incision has healed. The procedure usually lasts hours.
Hardware related complications during surgery is rare but can include catheter migration. And it may also help you avoid other side effects of pain medicine. Pain medicine works better when the pain first starts, before it gets too bad. Your doctor or nurse will set up a PCA pump to either give you medicine continuously or only when you press the button. In rare cases, it may be set up to do both. If you need more pain medicine than the PCA pump allows you to get, be sure to talk with your doctor.
Here's how the pump works:. Common pain medicines used in PCA pumps include hydromorphone and morphine. PCA pumps are most often used in the hospital after surgery, to help with moderate to severe pain. The pump allows you to give yourself pain medicine as you recover from your surgery, until you are able to start taking oral pain medicine.
It would be hard to give yourself too much pain medicine. Your doctor or nurse will set controls on the pump that limit the amount of pain medicine you get. Even if you press the button, the pump won't give you more medicine if it isn't time for your next dose. Sometimes family members or friends may offer to press the button on the PCA pump for you. 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.
A pump can help lessen spasticity muscle rigidity and spasms that make movement of the arms and legs difficult caused by:. Determining whether an implantable drug pump will be a good pain management option for you is a complex process. Before a permanent pump can be implanted, you must undergo a trial to see if the device decreases your level of pain or spasticity.
Depending on your particular condition, one of the following screening tests will be necessary:. During the trial, the doctor gathers information about the best location for the catheter and the type and amount of drug that works best for you. If the trial is successful, you will be scheduled for surgery.
You may be scheduled for presurgical tests e. 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 IV line is started in your arm. An anesthesiologist will explain the effects of anesthesia and its risks.
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. In both types of stimulation, a small implanted generator sends the electrical pulses and is attached by a wire to the leads.
During the trial period, an exterior generator is used. The patient is awakened during implantation surgery to provide feedback on where the pulses should be directed to relieve pain. Some patients have both spinal cord stimulation and peripheral nerve field therapy at the same time. Stimulation therapy does not eliminate all the pain, but pain is reduced by at least half for the majority of patients, leading to a major improvement in daily activities. See Advantages of Spinal Cord Stimulation.
Device-related problems are fairly common, and there is a small risk of infection. Serious complications, such as a hemorrhage or neurological damage—including paralysis—are rare. The other drawback is that spinal cord stimulation does not relieve pain for everyone who uses it. Medication is delivered directly to the spinal cord when an intrathecal pain pump is implanted.
Sending medication to the pain receptors near the spine interrupts pain signals to the brain, easing the perception of pain. To begin the procedure, the person is placed under local or general anesthesia.
A thin tube, or catheter, is inserted into the fluid-filled area around the spinal cord known as the intrathecal space. A small pump is implanted in the front of the body, usually in the abdomen, and the pump and catheter are attached.
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