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<title>Intrathecal pump</title>
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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Intrathecal pump</span></span>
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<p>An <b>intrathecal pump</b> is a <a href="Medical_device" title="Medical device">medical device</a> used to deliver (via an intrathecal <a href="Catheter" title="Catheter">catheter</a>) medications directly into the space between the <a href="Spinal_cord" title="Spinal cord">spinal cord</a> and the protective sheath surrounding the spinal cord. Medications such as <a href="Baclofen" title="Baclofen">baclofen</a>, <a href="Bupivacaine" title="Bupivacaine">bupivacaine</a>, <a href="Clonidine" title="Clonidine">clonidine</a>, <a href="Morphine" title="Morphine">morphine</a>, <a href="Hydromorphone" title="Hydromorphone">hydromorphone</a>, <a href="Fentanyl" title="Fentanyl">fentanyl</a>, or <a href="Ziconotide" title="Ziconotide">ziconotide</a> may be delivered in this manner to minimize the side effects often associated with the higher doses used in oral or intravenous delivery of these drugs.
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<div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2></div>
<ul><li>Some cancer patients with opioid resistant pain or serious side effects may benefit from intrathecal pain management.</li>
<li>Probably, only some benign patients with opioid resistant pain or serious side effects are suitable for intrathecal treatment.</li>
<li>Baclofen pumps are often used for individuals with spasticity associated with quadriplegia or paraplegia<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li></ul>
<div class="mw-heading mw-heading2"><h2 id="Application">Application</h2></div>
<p>People with <a href="Spastic_diplegia" title="Spastic diplegia">spastic diplegia</a> or other forms of <a href="Spasticity" title="Spasticity">spasticity</a>, or people in intolerable <a href="Pain" title="Pain">pain</a>, who cannot tolerate side effects of the higher-dose oral medications of the same medication type, are potential candidates for that medication being administered via an intrathecal pump.
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<div class="mw-heading mw-heading2"><h2 id="Construction">Construction</h2></div>
<p>The implantable intrathecal pump consists of a metal <a href="Pump" title="Pump">pump</a> which stores and delivers the medication, and an intrathecal catheter which delivers the medication from the pump to the intrathecal space in the spine where the medication takes effect. Two types of pumps are available: a constant rate pump delivers the medication at a constant rate, and a programmable pump delivers the medication according to a rate determined by a computer program.
</p><p>Also external pumps, with or without a <a href="Subcutaneous_injection" class="mw-redirect" title="Subcutaneous injection">subcutaneous</a> port are used for intrathecal delivery.
</p><p>The implantable medical device requires a surgical procedure; sometimes a <a href="Surgeon" title="Surgeon">surgeon</a> performs a trial intrathecal injection or implants a temporary intrathecal catheter and pump to determine if the medication works to begin with, and thus if a pump is appropriate. A permanent intrathecal pump is then implanted if the patient derives at least 50% improvement in his or her symptoms.
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<div class="mw-heading mw-heading2"><h2 id="Maintenance">Maintenance</h2></div>
<div class="mw-heading mw-heading3"><h3 id="Refills">Refills</h3></div>
<p>Intrathecal pumps require maintenance and need to be periodically refilled. How frequently this occurs is dependent on several factors, including drug concentration and dosage, and pump size. The refill frequency can range between one and six months for baclofen pumps.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>
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<div class="mw-heading mw-heading3"><h3 id="Replacement">Replacement</h3></div>
<p>Intrathecal pumps periodically need to be replaced. For baclofen pumps, this may be once every 5–7 years.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>
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<div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2></div>
<ul><li><a href="Infusion_pump" title="Infusion pump">Infusion pump</a></li>
<li><a href="Intrathecal_administration" title="Intrathecal administration">Intrathecal administration</a></li></ul>
<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>
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<li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">
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</style><cite id="CITEREFMedical_Advisory2005" class="citation journal cs1">Medical Advisory, Secretariat (2005). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382401">"Intrathecal baclofen pump for spasticity: an evidence-based analysis"</a>. <i>Ontario Health Technology Assessment Series</i>. <b>5</b> (7): <span class="nowrap">1–</span>93. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382401">3382401</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23074476">23074476</a>.</cite></span>
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<li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20160317212958/http://www.wch.sa.gov.au/services/az/divisions/pphealth/paedrehab/documents/IntrathecalBaclofenPumpsfactsheet.pdf">"Intrathecal Baclofen Pumps Fact Sheet"</a> <span class="cs1-format">(PDF)</span>. <i>Women's and Children's Hospital</i>. Government of South Australia. Archived from <a rel="nofollow" class="external text" href="http://www.wch.sa.gov.au/services/az/divisions/pphealth/paedrehab/documents/IntrathecalBaclofenPumpsfactsheet.pdf">the original</a> <span class="cs1-format">(PDF)</span> on 2016-03-17<span class="reference-accessdate">. Retrieved <span class="nowrap">2016-03-28</span></span>.</cite></span>
</li>
<li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://sci.washington.edu/info/forums/reports/intrathecal_baclofen.asp#maintain">"Intrathecal Baclofen Therapy for Spasticity"</a>. <i>sci.washington.edu</i><span class="reference-accessdate">. Retrieved <span class="nowrap">2016-03-28</span></span>.</cite></span>
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<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>
<ul><li><a rel="nofollow" class="external text" href="http://www.neuromodulation.com">International Neuromodulation Society</a></li>
<li><a rel="nofollow" class="external text" href="http://www.neuromodulation.org">North American Neuromodulation Society</a></li></ul></div><!--htdig_noindex--><div><div class="zim-footer">
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