morphine pump answers?

IT morphine 1 mg per day is equivalent to oral morphine 75 mg per day. Most patients require between 1 mg and 4 mg per 24 hours intrathecally to achieve reasonable comfort. This is equivalent to between 75 - 300 mg oral morphine per day. Even with this "Rolls Royce" technique, 100% pain relief is not attainable nor expected. Co-medication with paracetamol, NSAIDs, amitriptyline and gabapentin may still be necessary.


What is an Intrathecal Pump Implant ("Spinal Morphine Pump")?
An Intrathecal Pump is a specialized device, which delivers concentrated amounts of medication(s) into spinal cord area via a small catheter (tubing). What is an Intrathecal Pump Implant ("Spinal Morphine Pump")?
An Intrathecal Pump is a specialized device, which delivers concentrated amounts of medication(s) into spinal cord area via a small catheter (tubing).

Am I a candidate for Intrathecal Pump Implant ("Spinal Morphine Pump")?
Currently at TPM, Intrathecal Pump is offered to patients with :

Chronic and severe pain, who have not adequately responded to other treatment modalities. Some of the examples are failed back syndrome, cancer pain, RSD. These patients receive infusion of painkillers such as Morphine or Dilaudid.
Spastic disorders such as Multiple Sclerosis, Spinal Cord Injury - associated with muscle spasms. These patients receive infusion of an antispasmodic medication called Baclofen.
What is the purpose of it?
This device delivers concentrated amounts of medication into spinal cord area allowing the patient to decrease or eliminate the need for oral medications. It delivers medication around the clock, thus eliminating or minimizing breakthrough pain and/or other symptoms.

How long does the procedure take?
It is done in two stages. In the first stage, a single injection is made to assess effectiveness and screen for unwanted side effects. If this trial is successful in relieving symptoms, then the permanent device is placed under the skin. The patients have to meet certain other screening criteria before implanting the pump.

Will the procedure hurt?
The procedure involves inserting a needle through skin and deeper tissues (like a "tetanus shot"). So, there is some discomfort involved. However, we numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate.

What should I expect after the procedure?
If the procedure is successful, you may feel that your pain may be controlled or quite less. The pump is adjusted electronically to deliver adequate amount of medication.

What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. Please discuss your concerns with your physician.

Who should not have this procedure?
If you are on a blood thinning medication or if you have an active infection going on, you should not have the procedure. The patients also have to meet certain other screening criteria before implanting the pump.

[mr.lucky66]

I wish I could answer you question but it's too technical. Try the  pain mgt. section and I hope you get releif.

[nursegirl6572]

Are you asking for yourself?  I have worked with one of these pumps a few times while working hospice.

I'd be happy to tell you anything I know....

I DO know that some patients have had to have the procedure repeated due to it not being successful the 1st time, or after time, it needs re-done.

The 2 patients that I had the most exposure to this with were very happy with it...their pain was well controlled, and both of them said it was a relief not to have to deal with "breakthrough" pain....that that was one of the more challenging things...to find something that would help with the BT pains.