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Intrathecal Drug Delivery

Introduction to Intrathecal Drug Delivery
Patient Selection
Pumps and Pump Selection
Screening Test and Implant Techniques
Therapy Maintenance
Patient Management
Important Safety Information and Risks
Pain Clinician Home Page
Neurostimulation
Intrathecal Drug Delivery
Information for Patients 		Screening Test and Implant Techniques
*Introduction
*Screening Test
*Preoperative Considerations and Care
*Programmable Infusion System Implant Procedure
*Postoperative Care

Preoperative Considerations and Care

Training for key personnel should be conducted and arrangements for Therapy Maintenance should be made before a drug delivery system is implanted. (Also see Practice Components for other considerations.)

Please refer to the drug package insert for a complete list of warnings, precautions, dosing information and contraindications.

Once it has been determined that the patient is going to receive intrathecal drug delivery, the next responsibility is to conduct preoperative care and education.

Determining Implant Site

Prior to surgery, the clinician should confer with the patient to determine the pump pocket site. The following guidelines may be used in making the determination:
  • The pump should be placed where the skin will not be irritated by restrictive clothing and/or the sides of a wheelchair.
  • The pump should not be placed at the belt line. (This may be unavoidable in small or young patients.)
  • The pump should not be placed in an area where the patient receives radiation.
  • The pump should not be placed near the pelvic bone or rib cage.

Identifying and Controlling Infections

Prior to surgery, it is critical to detect the presence of infection. Laboratory testing (e.g., complete blood count differential and urinalysis) should be conducted one to two days prior to surgery. If the patient shows any sign of infection, the implant should be postponed until the infection is resolved. You may also want to consider treating the patient with pre- and perioperative prophylactic antibiotics.

Patient Informed Consent

During preoperative care, the patient should be instructed on his/her treatment and personal responsibilities. If you haven't done so already, review the Patient Informed Consent Form and educate the patient regarding its content. By reviewing the Informed Consent Form with a patient, a clinician can ensure that he or she has covered all the critical information regarding the therapy.

Primary areas to be covered during preoperative education and the Informed Consent process include:
  • Preoperative procedures
  • Implant procedure
  • Postoperative procedures
  • Postoperative pain or discomfort
  • Postoperative precautions and self-care responsibilities
  • Refill schedules and procedures
  • Follow-up care
  • Potential risks associated with surgery/therapy

For more information, see Patient and Family Education.

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To see Citations regarding Screening Test and Implant Techniques. . .

[Top]
*Introduction
*Screening Test
*Preoperative Considerations and Care
*Programmable Infusion System Implant Procedure
*Postoperative Care
Introduction to Intrathecal Drug Delivery | Patient Selection
Pumps and Pump Selection | Screening Test and Implant Techniques
Therapy Maintenance | Patient Management
Important Safety Information and Risks | Pain Clinician Home Page
Neurostimulation | Intrathecal Drug Delivery | Information for Patients


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