鞘内给药, 也被称为“镇痛泵”," uses a small pump to deliver pain medication directly to your spinal cord. The pump is surgically placed under the abdominal skin and delivers pain medication through a catheter to the area around your spinal cord.
鞘内给药
Because the pain medication is delivered directly to your spinal cord, 它可能比口服止痛药更有效, which must travel through your system before reaching your spine. The system can also control your pain with much smaller doses, which may reduce side effects.
鞘内给药 is used to treat pain from a variety of conditions, 比如慢性背部和颈部疼痛, 坐骨神经痛, 慢性腹痛, 背部和颈部手术失败, cancer and reflex sympathetic dystrophy or complex regional pain syndrome. Your doctor may recommend this treatment approach if other therapies have not been effective at reducing your pain, 或者如果你无法忍受其他疗法.
在植入永久性疼痛泵之前, most patients have a trial procedure to determine if they are a good candidate for a permanent pump. This usually involves using a needle to place a temporary spinal catheter, followed by an inpatient stay of several days while pain medication is infused through it. 在其他情况下, a single or series of pain medication injections around the spine are given on an outpatient basis. If your pain is better controlled or if side effects from your usual pain regimen are improved, you may be offered implantation of a permanent spinal drug pump.
准备
- Please arrange to have someone drive you home after the procedure, as you will not be able to drive or operate machinery for at least 24 hours after the procedure. You may have the option of staying in the hospital overnight depending on the circumstances.
- Do not eat or drink anything after midnight the night before the procedure, except for a small amount of water if needed to take medications on the day of the procedure.
- If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the procedure. Consult the doctor who manages your insulin or diabetes medication for any necessary adjustments. Bring your diabetes medication with you so you can take it after the procedure.
- If you take any blood thinning medications or antiplatelet medications, these must be stopped with the permission of your doctor who manages these medications.
- Continue to take all other medications with a small sip of water. Bring all medications with you so you can take them after the procedure. It is important to note that you must not stop taking any medication without first consulting with your primary or referring doctor.
过程
You will receive general anesthesia or sedation during the implantation. A small incision is made in the middle of your back so that the catheter — a small plastic tube — can be placed in the intrathecal space surrounding the spinal cord. An incision is made in the side of your abdomen below the waistline where the pump will be implanted, and the catheter is passed under the skin from your back to the abdomen pocket, 它在哪里连接到泵上. The pump is a round metal device about the size of a hockey puck. 一旦泵被正确定位, the incisions in your back and abdomen are closed with sutures or staples.
The pump is programmed to slowly release medication over a period of time. It can also be programmed to release different amounts of medication at different times of the day, 根据你的需要. The pump stores the information about your prescription in its memory, and your doctor can easily review this information with the programmer.
当蓄水池空了, the doctor or nurse refills the pump by inserting a needle through your skin and into the fill port on top of the reservoir.
复苏
严重的副作用和并发症并不常见. The most common problem is pain at the site where the pump was inserted. 十大赌博平台排行榜会给你止痛药来缓解疼痛. Your doctor will also discuss when you can resume your normal activities.
为了防止导尿管移位, please avoid the following activities for six to eight weeks after your surgery:
- Bending, twisting, stretching or lifting objects more than five pounds
- 把胳膊举过头顶
- 趴着睡
- 爬很多楼梯或长时间坐着
加州大学旧金山分校健康医学专家已经审查了这些信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.