Infusion Pump, Implantable, Non-Programmable (E0782)

Name of the Procedure:

• Common Names: Infusion Pump Implantation
• Technical/Medical Terms: Implantable Non-Programmable Infusion Pump

Summary

An infusion pump implantation involves surgically placing a pump under the skin that continuously delivers medication to specific areas of the body. This device is non-programmable and includes all necessary components, such as the pump, catheter, and connectors.

Purpose

• Medical Conditions: Chronic pain management, spasticity, certain types of cancer requiring chemotherapy, or severe muscle disorders.
• Goals/Outcomes: To provide consistent and controlled delivery of medications, improving symptom management and enhancing quality of life.

Indications

• Symptoms/Conditions: Severe chronic pain unresponsive to oral medications, muscle spasticity from conditions like multiple sclerosis or spinal cord injuries, certain types of cancer.
• Patient Criteria: Patients who have not responded well to other treatments, patients who require ongoing administration of medication at controlled rates.

Preparation

• Pre-procedure Instructions: Patients may be instructed to fast for a certain period before the procedure. They may need to adjust current medications under their doctor's guidance.
• Diagnostic Tests: Blood tests, imaging studies (such as MRI or CT scans), and consultations with anesthesia and surgical teams.

Procedure Description

1. Anesthesia: General anesthesia is typically administered.
2. Incision: A small incision is made where the pump will be placed, often in the abdominal area.
3. Placement: The pump is inserted under the skin, and a catheter is threaded from the pump to the area requiring medication delivery.
4. Connection: The catheter is connected to the pump, which holds and releases the medication at a preset rate.
5. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes around 1–2 hours.

Setting

The procedure is performed in a hospital or surgical center.

Personnel

• Surgeons specializing in the relevant medical field.
• Nurses.
• Anesthesiologists.
• Surgical Technicians.

Risks and Complications

• Common Risks: Infection at the implantation site, mechanical failure of the device, bleeding.
• Rare Risks: Nerve damage, allergic reaction to materials used in the device, catheter displacement.
• Complication Management: Prompt medical attention to manage infections, device adjustments or replacements, pain management protocols.

Benefits

• Expected Benefits: Effective, consistent delivery of medication, enhanced symptom control, reduced necessity for oral medications, improved quality of life.
• Realization Timeline: Benefits may be noticed almost immediately, though full benefits might take a few weeks to be fully realized.

Recovery

• Post-Procedure Care: Instructions on wound care, activity restrictions, signs of complications to watch for.
• Recovery Time: A few days to a week for initial recovery; several weeks for full adjustment.
• Follow-Up: Regular follow-up appointments to monitor device function and medication levels.

Alternatives

• Other Options: Oral or injectable medications, external infusion pumps, nerve blocks, physical therapy.
• Pros and Cons: Oral medications may be easier to use but less effective; external pumps avoid surgery but can be cumbersome; nerve blocks and physical therapy may offer relief but often less consistently.

Patient Experience

• During Procedure: Under general anesthesia, so the patient will not experience pain during the procedure.
• After Procedure: Some soreness or discomfort at the incision site; pain is generally managed with prescribed medications. The patient will receive detailed instructions to ensure comfort and promote healing.