Only the very worst cases of extremely severe pain are considered. Prior to declaring pump candidacy, the individual considering this treatment option must have been through an entire gamete of oral opioid medication options and have failed miserably. Usually this individual has pain from a malignancy, but occasionally people with non-malignant pain are considered.
each candidate will face a life-long laundry list of potential mechanical complications.The catheter can kink, obstruct, dislodge, and disconnect. The pump can fail from battery depletion, pump inversion, pump erosion or technical difficulties.
This is the first article I’ve seen that points out the disadvantages and problems with these “pain pumps”. Looking through the promotional material makes it seem utterly simple and mostly without complications. Once again, the truth is completely different from the advertisements.
These mechanical failures are not something that any old hospital doctor can take care of as if he/she is the local one-stop pump mechanic. No, these failures are potentially life-threatening problems causing acute opioid withdrawal symptoms that require specialty care not found at a majority of health care centers.
These pumps are manufactured by one company alone. Without any competition in this market, there has been no motivation to improve this technology. The unreliability of these pumps is notorious
pump delivering pain medications into the spinal canal have a 1 in 20 chance of death from overdose. The 4 percent chance of death is higher than what anyone who has routine anesthesia for surgery will face.
every four to five years the pump will need to be surgically replaced
there are not many benefits to be gained from the intrathecal opioid pump.
Those who have extreme pain and opt for the pump are usually still miserable because the pain is still severe. The pain score might reduce slightly, but remains very high. Is that enough to for someone to have a reasonable quality of life for years to come? Maybe, maybe not.
The only people who really can benefit the most are individuals with malignant pain. What little life is left will be prolonged because the pain will be kept manageable enough for the person to remain functional and get his/her affairs in order. The shortened life expectancy from the malignancy negates any potential for pump failures and needs for replacements in the future. In other words, a person with cancer will not be around long enough for a majority of pump problems to become a problem.
Yes, the reality about intrathecal opioid pumps is bleak because only in rare cases do the benefits outweigh the risks