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IMPLANT TARGETED DRUG DELIVERY

THE IMPLANT PROCEDURE

If you and your physician decide targeted drug delivery is right for you, the pump will be implanted during a surgical procedure. This procedure is most often performed in a hospital or outpatient surgery center.

Before the procedure, you and your physician will decide where in your abdomen to position the drug pump for your comfort. You should not undergo the implant procedure if you have an active infection at the time of your scheduled appointment.

GENERAL STEPS

The steps and time will vary depending on the doctor.

  1. Typically, the implant is performed under general anesthesia.
  2. Your doctor makes an incision, about 6 inches long, in the abdomen.
  3. He or she will form a pocket in the incision, large enough to hold the pump.
  4. A second incision, about 2 to 3 inches long, is made on your back. This incision is used to place one end of the catheter into the intrathecal space.
  5. The other end of the catheter is placed under the skin and connected to the pump, resulting in a fully implanted system.
  6. Once the pump and catheter are in place, the doctor closes the incisions and completes the surgery.
  7. The length of your hospital stay will vary depending on your doctor’s preference and hospital procedures.

 

THE FIRST WEEKS OF RECOVERY

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The recovery time after getting the pump implanted is usually 6–8 weeks. You may experience some initial discomfort and limits on movements. Be sure to listen to your body and follow your physician's instructions.

After a few weeks, it's a good idea to try some activities you enjoy, such as going for a walk, riding your bike, going to a movie, or watching a ball game. Talk with your physician about activities you'd like to try or tasks you'd like to accomplish.

PERSONAL THERAPY MANAGER

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If your physician prescribes it, you may receive a personal therapy management handheld device to help alleviate your unpredictable pain. It works with your implanted pump and allows you to get an extra dose, or bolus, of medication when needed and within limits set by your physician.

Patients experience higher levels of therapy satisfaction with such a personal therapy management device.  It offers simple bolus delivery, clear lockout timer, and convenient access to therapy details such as refill date. Ask your clinician about having it prescribed with your therapy.

CUSTOMIZING AND ADJUSTING YOUR PAIN THERAPY

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Your physician will program the pump to meet your individual needs so that you receive the best pain relief possible. For example, to prevent pain from interfering with sleep, the pump can be programmed to deliver more pain medicine at night. Be sure to tell your physician about the way you feel, so changes can be made to optimize your pain management.

YOUR REFILL APPOINTMENT

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During the refill appointment, your physician will assess your symptoms, check that your drug delivery system is working properly, and confirm you are receiving appropriate therapy.

The drug pump will be emptied with a needle inserted through your skin. The pump will then be refilled with medication. This is a relatively short procedure. How often your pump needs to be refilled depends on your individual dosing schedule and the size of your drug pump.

 

DAILY LIFE WITH TARGETED DRUG DELIVERY

Talk with your physician about the types of activities that may be easier with targeted drug delivery. Develop a plan for doing the things that matter most to you. Setting goals is important to get the most out of long- term drug delivery therapy.

Once you have a targeted drug delivery system, you will need to call your physician right away if you:

  • Experience additional or unusual pain
  • Notice any increase or new drug side effects
  • Think you need to increase the intensity of your therapy
  • Hear the pump alarm

RISKS OF TARGETED DRUG DELIVERY

Pump or catheter problems can occur after implantation, which may require corrective surgery and/or cause a drug overdose or underdose that may be serious or life-threatening. Implanting the system has risks similar to any surgical procedure, including infection. Drugs infused through the system may result in adverse events. Errors in locating the pump during the refill procedure can result in symptoms of overdose that may be serious or life-threatening.

Always discuss the potential risks and benefits of the therapy with your physician.

1

Bolash, Niazi, Kumari, Azer, Mekhail. Pain Pract. Efficacy of a Targeted Drug Delivery on-Demand Bolus Option for Chronic Pain. 2018 Mar;18(3):305-313.

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.