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Intrathecal Pump Trials

Intrathecal medication are used in patients who have failed all other conservative treatments and are not a candidate for surgery. Small doses of narcotic with or without non-narcotic medication is infused into the spinal fluid surrounding the spinal cord to interrupt transmission of pain signals between your spinal cord and brain.

Pump trial is the first step in the process. You will have an intrathecal catheter placed in the Pain Clinic. This catheter will be connected to an infusion pump containing the pain medicine with or without numbing medicine. You will be admitted to the hospital for 48 hours.  This is to monitor your response to the intrathecal medication and adjust the medication dose until you get optimum pain relief.   Any side effects from intrathecal medication will be monitored and treated accordingly during this period.

How do I prepare for the procedure?

You may have clear liquids after midnight until 2 hours before your appointment and then nothing to eat or drink.  Clear liquids include Jell-O, broth, 7-Up, tea, coffee and apple juice.  No milk or milk products.  You may take all your normal medications, including pain medication with a sip of water.
If you are diabetic or have a bleeding disorder or take medications such as Coumadin, Lovenox, Plavix or Aggrenox that affect your bleeding, please call us at 570-271-6621.
Bring a list of your medications including dose and how often you take them.

What happens during the procedure?

  • An intravenous will be started and you will be given relaxing medicine.
  • An intravenous will be started and you will be given relaxing medicine.
  • The area of the catheter insertion will be numbed
  • A small catheter is inserted into the intrathecal space.
  • A small amount of numbing medicine will be given through the catheter to test for pain relief.
  • The catheter will be tunneled under your skin and secured to reduce the risk of infection.
  • The area will have a dressing applied and you will be taken to the recovery room.

What happens in the recovery room?

  • Your vital signs will be monitored
  • The medication infusion will be started and you will be monitored for at least an hour before going to your room.

What happen after admission?

Your doctor will come to see you later that afternoon to see if you are getting adequate pain relief or experiencing any side effects of the medication: drowsy, nausea, itching or numbness. The dose will be adjusted accordingly by the physician. You will be seen next morning. The adequacy of pain relief and side effects will be monitored during these two days.  Once sufficient information is gathered, the catheter will be removed and you will be discharged to home.

Discharge instructions

  • Take it easy the remainder of the day
  • You may resume your normal activities the next day.
  • Report fever, redness or drainage at catheter site.
  • If you obtain adequate pain relief during the trial period then a referral will be sent to the neurosurgeon for the placement of a permanent intrathecal pump. This implantation will not be done for at least 1 month to decrease the risk of infection.