تعريف

Intrathecal pain pump insertion is a procedure to help with pain management. A small pump will be inserted in your body. The pump will be able to deliver pain medicine to the area around your spinal cord.

أسباب هذا الإجراء

This pain management technique is often only used if noninvasive pain management has failed or has negative side effects. An intrathecal pain pump can be used to manage long term pain problems caused by:

  • Failed back or neck surgery syndrome
  • Compression fractures
  • Phantom limb pain
  • Cancer
  • Reflex sympathetic dystrophy —nervous system disease
  • Causalgia —burning pain due to peripheral nerve injury
  • Arachnoiditis—inflammation of the spinal nerves
  • Chronic pancreatitis —inflammation of the pancreas

Many people have a significant reduction in pain and are better able to function in daily life after having an intrathecal pain pump insertion.

Compression Fracture

المضاعفات المحتملة

Complications are rare. But no procedure is completely free of risk. If you are planning to have a pump inserted, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:

  • نزيف
  • العدوى
  • Spinal headaches
  • Catheter tube becomes blocked and stops working
  • Side effects from the pain medicine
  • Pump-related complications
  • إصابة الأعصاب

تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:

  • Psychological problems
  • Active infection
  • Allergy or intolerance to the pain medicine or materials being used
  • Bleeding disorders, concurrent anticoagulation therapy

ما يمكن توقعه

قبل الإجراء

قد يقوم طبيبك بما يلي:

  • اختبار بدني
  • تحاليل الدم
  • Electrocardiogram (ECG, EKG)
  • الأشعة السينية الصدر
  • MRI of the spine

Before the surgery, you will undergo a trial to see if the pump will actually decrease your pain. Pain medicine will be injected into the area around your spine one or more times. In some test trials, a catheter may be placed in the area around your spine. The catheter is then connected to an external pump. The proper placement of the catheter and ideal dose of medicine for you will also be found in the trial period.

Cervical Injection

المؤدية إلى الإجراء الخاص بك:

  • Do not eat anything after midnight the night before your surgery, unless directed otherwise by your doctor.
  • Arrange to have someone drive you to and from the procedure.
  • Arrange for help at home after your procedure.

التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:

  • الأسبرين أو غيره من العقاقير المضادة للالتهابات
  • مميعات الدم ، مثل كلوبيدوجريل أو وارفارين

التخدير

Local, spinal, or general anesthesia may be used.

وصف الإجراء

To place the catheter, a small incision will be made in your back. A small tube (called a spinal catheter) will be placed near your spinal cord. It will be secured with sutures. An x-ray machine will be used to help guide the catheter. The catheter will travel under your skin from your spine, around your torso, and into the abdomen. A pocket will be made under the skin of your abdomen. The pump will be placed into this pocket.

After the device is in place, you will be woken. The pump will be tested. The incisions in your back and abdomen will be closed with sutures or staples. The area will be covered with bandages.

بعد العملية

After the procedure, you will be taken to a recovery area. Your blood pressure, heart rate, and breathing will be monitored, as well as any potential side effects, like:

  • Sedation
  • Slow breathing
  • إمساك
  • مثير للحكة
  • استفراغ و غثيان
  • الصداع
  • التحريض

كم من الوقت سيستغرق ؟

About 3-4 hours.

هل سيكون هناك ألم؟

You will be under anesthesia for the procedure. You should not feel pain. You will experience some pain after the surgery. It will be managed with medicines.

رعاية ما بعد العملية

After returning home, you should do the following:

  • Avoid bending, twisting, stretching, lifting objects over five pounds, raising your arms above your head, sleeping on your stomach, climbing a lot of stairs, or sitting for long periods of time for 6-8 weeks.
  • Avoid driving for 2-4 weeks after surgery.
  • Do not do housework or yard work or resume النشاط الجنسي until you have had your follow-up appointment with your doctor.
  • عد تدريجيًا إلى أنشطتك الطبيعية.
  • Walk short distances at first, and after 2 weeks, gradually increase to 1-2 miles daily.
  • اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
  • تأكد من اتباع تعليمات طبيبك .

You will need to carry an Implanted Device identification card, since the pump will set off metal detectors (eg, at airport security gates). The battery in your pump will need to be replaced every 5-7 years. You will need to go for regular visits to your doctor to have the pump reservoir refilled with medicine at regular intervals.

استدعاء الطبيب

بعد وصوله الى المنزل ، اتصل بطبيبك إذا كان أي من الحالات التالية:

  • Redness, swelling, pain, or discharge around an incision site
  • Uncontrolled pain or pain that is progressively getting worse
  • Sudden ألم في الظهر
  • Opioid withdrawal symptoms: rapid breathing, perspiration, runny nose, agitation, increased heart rate, fever, tremors, muscle twitching, aching muscles, loss of appetite, abdominal cramps, diarrhea
  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • Loss of bowel or bladder function
  • Headache lasting longer than 48 hours
  • Beeping noises from pump
  • Sudden onset of leg weakness and spasm
  • الغثيان و/أو القيء
  • السعال، ضيق التنفس، أو ألم في الصدر

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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