Name of the Procedure:

Infusion Pump, Non-Programmable, Permanent (Implantable)
Common Name(s): Implantable Infusion Pump, Pain Pump
Technical/Medical Term: Non-Programmable Infusion Pump Implantation

Summary

An infusion pump is a small, surgically implanted device that delivers medication directly to a specific area within the body. This non-programmable, permanent pump continuously releases a set amount of medication to manage chronic pain, muscle spasticity, or other conditions requiring continuous drug delivery.

Purpose

This procedure is used to manage chronic pain or muscle spasticity that has not responded to other treatments. By providing a constant flow of medication directly to the affected area, the pump helps reduce symptoms and improve quality of life.

Indications

• Chronic pain conditions (e.g., cancer pain, neuropathic pain)
• Severe spasticity (e.g., due to multiple sclerosis or spinal cord injury)
• Patients for whom oral medications are ineffective or cause intolerable side effects

Preparation

• Fasting for at least 8 hours prior
• Medication adjustments as advised by the doctor
• Pre-operative diagnostic tests (e.g., MRI, blood tests) to ensure proper placement and patient suitability

Procedure Description

1. Incision: A small incision is made in the abdomen.
2. Pocket Creation: A pocket is created under the skin to hold the pump.
3. Pump Placement: The pump is placed into the pocket and secured.
4. Catheter Insertion: A catheter is threaded under the skin from the pump to the specific site of medication delivery (e.g., spinal column).
5. Testing: The pump and catheter are tested to ensure proper function.
6. Closure: Incisions are closed with sutures and bandaged.

Equipment Used: Surgical instruments, implantable infusion pump, catheter
Anesthesia: General anesthesia or spinal/epidural anesthesia

Duration

The procedure typically takes 1 to 2 hours.

Setting

Performed in a hospital operating room or a surgical center.

Personnel

• Surgeon specialized in pain management or neurosurgery
• Anesthesiologist or nurse anesthetist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the incision site
• Pump or catheter malfunction
• Bleeding or bruising
• Allergic reaction to anesthesia
• Spinal fluid leakage

Benefits

• Significant reduction in chronic pain or spasticity
• Lower doses of medication compared to oral administration
• Improved daily functioning and quality of life
• Benefits may be realized within days to a few weeks

Recovery

• Patients typically stay in the hospital for 1-2 days
• Wound care instructions provided
• Activity restrictions for a few weeks to allow healing
• Follow-up appointments to adjust medication dosage and check pump function

Alternatives

• Oral medications (e.g., opioids, muscle relaxants)
• Non-implantable infusion pumps
• Alternative therapies (e.g., physical therapy, nerve blocks)

Pros of Alternatives: Less invasive, no surgical risks
Cons of Alternatives: Potentially less effective, higher systemic medication side effects

Patient Experience

• Post-operative pain manageable with prescribed pain relievers
• Mild discomfort and swelling at incision site
• Gradual return to normal activities over a few weeks
• Regular follow-up visits for pump refills and adjustments