Name of the Procedure:

Electronic Analysis of Programmable, Implanted Pump for Intrathecal or Epidural Drug Infusion (Includes Evaluation of Reservoir Status, Alarm Status, Drug Prescription Status); with Reprogramming and Refill

Summary

This procedure involves examining and adjusting a programmable pump implanted under the skin, which delivers medication directly to the spinal area. These pumps are often used for pain management or to treat spasticity. The procedure includes checking the pump’s status and refilling it with medication.

Purpose

This procedure addresses chronic pain or spasticity by ensuring the implanted pump effectively delivers the medication. The goals are to verify the proper operation of the pump, update the medication dosage if necessary, and refill the pump's reservoir.

Indications

• Chronic pain unresponsive to oral medications
• Severe spasticity related to conditions such as multiple sclerosis or spinal cord injury
• Need for precise and consistent medication delivery to the spinal area
• Patients with existing intrathecal or epidural pumps that require maintenance

Preparation

• Fasting is generally not required.
• Patients should inform their physician of any medications or supplements they are taking.
• An MRI or X-ray may be needed to ensure the pump’s proper positioning.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. The site over the pump is cleaned and sterilized.
3. Using a specialized programmer, the physician accesses the pump’s electronic settings.
4. The physician evaluates the current reservoir status, alarm status, and drug prescription settings.
5. Adjustments to the medication dosage and delivery schedule are made as necessary.
6. The reservoir is refilled with the prescribed medication using a syringe and needle.
7. The pump is tested to confirm appropriate function before completing the procedure.

Tools used include:

• Programmable pump
• Electronic programmer device
• Syringe and needle for refilling
• Sterile cleaning materials

This procedure typically does not require anesthesia, but local anesthesia at the refill site may be used.

Duration

Usually takes about 30 to 60 minutes.

Setting

Typically performed in an outpatient clinic or a hospital setting.

Personnel

• Physician or other qualified healthcare professionals
• Nurse to assist with the procedure and patient care

Risks and Complications

• Infection at the pump site
• Bleeding or bruising
• Malfunction of the pump or catheter
• Allergic reaction to the medication

Benefits

• Improved pain control
• Reduction in spasms and increased mobility
• Less reliance on oral medications and their potential side effects
• Immediate adjustments to medication delivery can be made

Recovery

• Patients can usually go home shortly after the procedure.
• Keep the site clean and dry.
• Avoid strenuous activities for 24-48 hours.
• Follow-up appointments as recommended for ongoing pump maintenance.

Alternatives

• Oral or transdermal medications
• External pain pumps
• Physical therapy
• Surgery for pain relief in specific cases

Each alternative comes with its own set of risks and benefits, and the choice may depend on the patient’s specific condition and response to previous treatments.

Patient Experience

During the procedure, patients may feel slight discomfort at the injection site. Post-procedure, there might be minor soreness or bruising. Pain management options include over-the-counter pain relievers and applying ice packs. Most patients can resume normal activities within a couple of days.