Dr Naoufel Ouerchefani Functional neurosurgeon - Pain doctorPain and abnormal movement surgeon

Intrathecal pump

Your hospitalization

You will be accepted into the hospital’s neurosurgical operation room one day before the surgery. You will talk to your surgeon, as well as the nurse specialized in pain. A pre-operative blood-draw will be performed so as to prepare the anesthesia. You will have to avoid eating for 6 hours before the surgical intervention.

The operation will take place under general anesthesia, under a radioscopic detection system. It lasts around 1h30.

Once you leave the operation room, you will be followed in a recovery room in order to be monitored for 24 to 48 hours.

How the operation takes place

The surgeon punctures the lumbar area and places the catheter in the sub-arachnoid space. The flow of the cerebrospinal fluid will confirm that the catheter is well-positioned. The latter is then pushed forward towards the skull until the desired position (either thoracic or cervical) is achieved, depending on where the pain is located.

An incision is made in the abdominal area to prepare the pocket that will contain the pump, as well as the passage for the catheter’s network system. In the lumbar area, the two catheters are connected thanks to a subcutaneous device. In the abdominal area, the catheter is hooked up to the pump that will be pulled up into the subcutaneous capsule made under the incision.

Activating the pump

The pump is filled with a mix of 3 pain-killing products (Morphine, Ropivaïne, and Prialt) which is prepared in the pharmacy in pre-filled syringe, then transferred to the operating room. The concentration and the volume are carefully determined according to the estimated needs. The products’ concentration can be modified during a future fill-up, if necessary.

The pump is activated at the end of the intervention, and, in the following half-hour, the mix reaches a dose in the cerebrospinal fluid which is “supposedly effective”. You should, from then on, feel some relief.