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Benefits and Risks – Drug Pumps

Studies show that drug pumps (intrathecal drug delivery systems) may relieve cancer pain and increase comfort for people with severe pain.1-4 Talk with your doctor about the benefits, risks, and responsibilities involved with using a drug pump for cancer pain management.

Benefits

According to surveys of patients and caregivers, drug pumps improve quality of life.4 Typically, people who have success with intrathecal drug treatment:

  • Experience significant pain control1-4
  • Use significantly smaller doses than oral medication1-4
  • Experience fewer side effects4
  • Improve their ability to function and participate in activities of daily living1-4
  • Improve their quality of life4

In addition, this treatment:

  • Allows the dosage to be adjusted for your comfort
  • Is reversible -- your doctor can turn off the therapy or surgically remove the system

Risks

The drug pump is surgically placed in the abdomen and connected to the catheter, which is placed in the spinal column. Surgical complications are possible and include infection, spinal fluid leak, and headache. You should not undergo the implant procedure if you have an active infection at the time scheduled for implant surgery.

Once the infusion system is implanted, device complications may occur which require surgery to resolve. Drug overdose or underdose can result because of these complications, which have serious and even life-threatening adverse effects. Possible complications include the catheter or pump moving within the body or wearing through the skin. The catheter may leak, tear, kink, or become disconnected. The pump may stop because the battery has run out or because another part of the infusion system has failed. Additionally, inflammatory masses have been reported at the tip of the catheter which may lead to complications, including paralysis.

See Important safety information for more details. Also, please discuss the benefits and risks of this therapy with your doctor.

References

  1. Onofrio BM, Yaksh TL. Long-Term Pain Relief Produced by Intrathecal Infusion in 53 Patients. J Neurosurg 1990; 72: 200-209.
  2. Lamer TJ. Treatment of Cancer-Related Pain: When Orally Administered Medications Fail. Mayo Clin Proc 1994; 69:473-480.
  3. Portenoy RK. Management of Common Opioid Side Effects During Long-Term Therapy of Cancer Pain. Ann Acad Med 1994; 23:160-170.
  4. Smith TJ, Staats PS, Deer T, Randomized Clinical Trial of an Implantable Drug Delivery System Compared with Comprehensive Medical Management for Refractory Cancer Pain: Impact on Pain, Drug-Related Toxicity and Survival. J Clin Oncol. 2002;20:4040-4049.
  5. Medtronic SynchroMed II Programmable Infusion System Clinical Reference Guide—Intrathecal Morphine for Pain Management. (NP5256b)
  6. Medtronic Implantable Systems Performance Registry (ISPR). 2009 Medtronic Product Performance Report: Data through October 24, 2008.
  7. Medtronic SynchroMed II Drug Infusion System Brief Summary. October 2009.
  8. Coffey RJ, Owens ML, Broste SK, Dubois MY, Ferrante FM, Schultz DM, Stearns LJ, Turner MS. Mortality associated with implantation and management of intrathecal opioid drug infusion systems to treat noncancer pain. Anesthesiol. 2009;111(4):881-91.

     

 

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.

Last updated: 9 Dec 2011

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