Questions and Answers – Getting a Drug Pump
Chronic Pain
- How will my doctor know if I am a candidate for a drug pump?
- Why do I have to undergo the screening trial?
- How long does the screening trial take? Do I have to stay in the hospital?
- Will it hurt?
- Can I have other pain medication during the screening trial?
- Will I receive the same relief that I get during the screening trial when I receive my permanent drug pump?
- How long after the screening trial is the drug pump implanted?
- What type of anesthesia is used during the implant?
- What is the average length of the hospital stay?
- On average, how long does the surgery take?
- How big are the incisions?
- Is spinal cord damage a possible complication?
- Can a previous abdominal incision be used?
- How long will it take before I start receiving benefit from my pump?
- How often will the pump need to be refilled?
- Will people be able to see that I have a pump?
- What if my pain changes? Can my doctor increase or decrease my dosage?
- Can the pump be removed?
How will my doctor know if I am a candidate for a drug pump?
Talk to your doctor about what you would like to achieve with your treatment. Your doctor will do a screening trial to determine whether a drug pump will provide adequate pain relief or help you meet your goals.
Why do I have to undergo the screening trial?
A trial is a way for you and your doctor to evaluate your response to the medication delivered into your spinal region, to see if you are a candidate for a drug pump.
How long does the screening trial take? Do I have to stay in the hospital?
This will vary depending on the type of screening trial your doctor feels would be best for you. The trial could take as little as one day, and up to 4 days. Depending on the type of trial, you may undergo a procedure that takes approximately 1 to 2 hours plus additional time to be monitored in the hospital or surgery center after the procedure. Consult your doctor to understand the details for the type of trial he or she thinks would be best for you.
Will it hurt?
Before you are given the screening trial injection or the catheter is placed, your doctor may numb a small region of your lower back with a local anesthetic.
Can I have other pain medication during the screening trial?
This will depend on your doctor and your pain level. Your doctor may gradually reduce or withdraw your oral medication(s) 1 to 2 weeks prior to the trial.
Will I receive the same relief that I get during the screening trial when I receive my permanent drug pump?
If the trial has been successful and you go on to receive the implanted system, your pain relief may differ slightly. Be sure to tell your clinician about the way you feel so that changes can be made that will give you the best pain relief possible.
How long after the screening trial is the drug pump implanted?
If you decide to proceed with targeted drug delivery, there will be a waiting period after the trial and before your implant procedure. This will give the incision in your back time to heal and allow time for your insurance provider to be notified, and for the surgery to be scheduled.
What type of anesthesia is used during the implant?
Typically, the implant is performed under general anesthesia. However, you may wish to talk with your doctor about other options.
What is the average length of the hospital stay?
Depending on your doctor's preference and hospital policy, a 1- to 2-night hospital stay may be recommended.
On average, how long does the surgery take?
On average, the procedure takes about 1 to 3 hours from start to finish. Talk with your doctor about the specifics and duration of your procedure.
How big are the incisions?
There are two incisions. One is for the pump and is located in your abdomen. The size of the incision depends on the size of the device and could be up to 6 inches long. The other incision, made on your back, is 2 to 3 inches long.
Is spinal cord damage a possible complication?
Spinal cord injury may occur from surgical placement of the catheter.
Can a previous abdominal incision be used?
Usually not. The incision needs to be made where the pump will be implanted to help properly anchor the pump. Proper anchoring helps keep the drug pump in place. This may help minimize your discomfort and speed recovery.
How long will it take before I start receiving benefit from my pump?
You will begin receiving treatment as soon as your pump is filled and programmed to deliver the prescribed amount of pain medication through the catheter into the intrathecal space. Keep in mind, however, that it takes time to achieve an appropriate balance between pain relief, progress toward goals, and managing side effects.
How often will the pump need to be refilled?
The medication in your pump may need to be refilled every 6 weeks to 6 months. The frequency of refills depends on the drug concentration and the amount of pain medication you receive every day. A higher dosage requires more frequent filling. The pump is refilled by a needle injection in your doctor’s office. During these appointments your doctor can adjust your dose of medication to address your pain relief needs.
Will people be able to see that I have a pump?
Because your pump is placed near the surface of your skin for refill access, on occasion someone might notice a slight bump if you are wearing fitted clothes. However, depending on your size and shape, where the pump is implanted, and the size of your pump, it may not show under your clothes at all.
What if my pain changes? Can my doctor increase or decrease my dosage?
Yes. After implantation, your doctor can make changes in dosage requirements.
Can the pump be removed?
If you no longer need the pump or change your mind about the treatment, your doctor can turn it off or surgically remove the system.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.