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Intrathecal Drug Delivery System
In this Intrathecal Drug Delivery System, medicine is delivered directly to the fluid around the spinal cord. It includes a drug pump, that is connected to catheter (thin,flexible tube/wire).
Pump & catheter are implanted under skin. Pump should be refilled regulatory. Interval varies from weeks to months.
INDICATION:-
When other systemic analgesic methods(oral, intravenous, transdermal)are ineffective/produces too much side effects.
When intra spinal analgesia has been shown to provide better pain relief by previous trial testing.
Procedure:-
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, where it is attached to the pump. The pump is a round metal device about the size of a hockey puck. Once the pump is correctly positioned, the incisions in your back and abdomen are closed with sutures or staples.
Most commonly used USA FDA approved are morphine, ziconotide, baclofen. Also use of many opiods/non-opiods mention.
EFFICACY & ADVANTAGE:-
- Lessen the requirement of drug.
- Lessen the chances of side effects of drug.
- Excellent evidence for use of intrathecal baclofen for spasticity.
- IDS combined with medical management for cancer pain helps to reduce pain/side effects.