Transcript PowerPoint Presentation - Electrical, Computer & Biomedical

Intrathecal Pumps
Thomas Yeargin
Biomedical Engineering
BME 281 Section 1
What is an Intrathecal Pump?
• Method of giving medication directly to the spine to
cure intolerable pains
• Small pump surgically placed under skin of
abdomen
• Delivers medication, usually morphine, through a
catheter to intrathecal space of spine
• Can release medication slowly over period of time or
can be programmed to release different amounts
periodically
Reasons for Intrathecal Pumps
• If one is dependent on pain
medication
• If one could not benefit
from additional surgeries
• Cancer pains
• Lessen spasticity from
cerebral palsy or multiple
sclerosis
http://www.swarminteractive.com/images/thumbs/pumpimplant_300.jpg
Is it for you?
• Must go through complex trial to see if treatment
decreases pain/spasticity
• Single injection through lumbar puncture
• Multiple injections over the course of days
• Continuous trial- catheter placed in correct area of
the spine connected to external pump
• Dose is increased every two hours until patient feels
pain relief
Types of Intrathecal
Pumps
• Two major types of intrathecal
pumps:
• Implanted pump with a constant
flow rate
-dosage cannot be changed
• Fully implanted pump with
programmable pump
-Programmed by computer
so doctors can change dosages to
meet patients needs
http://www.medgadget.com/2012/09/ascenda-a-stronger-catheter-formedtronics-baclofen-synchromed-ii-pump.html
Medications
• First line of medication is morphine, provides good
analgesia in patients
• Second line of medication is morphine with the
addition of bupivacaine or clonidine
-better for patients with neuropathic symptoms
• Third line is the combination of both bupivacaine
and clonidine with morphine
-Third line only used if line one and two fail
Surgery
• Takes about 3-4 hours
• Catheter is placed in intrathecal
space of spine
• Pump is placed in between skin
and muscle layers of the abdomen
• An extension catheter is passed
under the skin from the spine to
the abdomen to connect to the
pump.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080496/
Living With the Pump
• Must schedule medication refills on a regular basis
• Effectiveness of treatment will be assessed at the
checkups
• Tell doctor if feeling unusual symptoms or drug
overdose
• Withdrawal symptoms could happen and can
possibly be very dangerous
Risks/Side Effects
• Infection or bleeding from the surgery
• It is very rare but the catheter could move out of
place or the pump could stop working
• Accumulation of cerebrospinal fluid around the
pump causes a watery discharge from incisions or
headaches
• Side effects could include respiratory depression,
twitching, muscle spasms and nausea
Results of Pump
• Depends on the severity of the condition of the
patient
• Chronic patients experience a reduction of pain as
well as overall improvement in everyday activities
• Spasticity patients experience a reduction in rigidity
and muscle spasms
• Oral medications are reduced because of the direct
delivery of medication to the spinal cord from the
pump
Conclusion
• It has already surpassed oral medication and is
proven more efficient
• Most patients find that this type of medication
works well for them and there are not many risks or
side effects that come with it
• If researchers can find a better design for the
catheters then the future for this pump is very bright
Questions??
References
•
[1] Mayfield Clinic and Spine Institute. " intrathecal Drug Pump." Pain
Pump, Intrathecal Drug Delivery, Drug Pump. N.p., Mar. 2013. Web. 16
Oct. 2015. <http://www.mayfieldclinic.com/PEPUMP.htm#.ViBO27RViko>.
•
[2] Knight, Karen H. et al. “Implantable Intrathecal Pumps for Chronic
Pain: Highlights and Updates.” Croatian medical journal 48.1 (2007):
22–34. Print.
•
[3] Lee, Kung-Shing, Kowng-Shing Chu, Chia-Li Chung, Chiuh-Lung
Lin, Shiuh-Ling Hwang, and Shen-Long Howng. "Review Article
Intrathecal Drug Delivery System with Programmable Morphine Pump
for Pain of Terminally Ill Cancer Patients." CiteSeerX. N.p., 2009. Web.
17 Oct. 2015.
http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.537.7707&ra
nk=27.