Intrathecal pump management

How does it work?

It consists of a small drug reservoir which is connected to a catheter (small tube) placed near the spinal cord. The pump releases small amounts of concentrated medication close to the spinal cord where it works. 

How are they inserted?

An intrathecal pump is inserted as a surgical procedure in a clean operating theatre. It is usually performed as a day case procedure and patients are allowed home the same or the next day. Patients lie face down on an operating table and using x-ray guidance, the catheter is placed through the skin into the appropriate place near the spinal cord. The other end either comes out of the back and is plugged into an external battery that looks a bit like a pager device or is tunnelled under the skin and is plugged into a battery which is placed under the skin, normally in the chest or buttock.

Is this done under a general or local anaesthetic?

You must be awake when a intrathecal pump is sited for safety reasons. But an anaesthetist will care for you and ensure that you are comfortable during the procedure.

Potential issues and/or complications

These risks are generally rare but include serious complications such as paralysis, serious spinal or neurological infection and severe allergic reaction to drugs. These will be discussed with you on an individual basis by your consultant, and you will be given an opportunity to reflect on and ask questions before committing to anything.