At Home Care I.V. of Bend, we specialize in intravenous and intrathecal pain management therapies. From the hospice patient who needs end-of-life pain relief to the post-op management of jaw surgery, failed back syndrome or other chonic pain, intravenous pain management can mean an improved quality of life!
Pain medications can be delivered intravenously via a Computerized Ambulatory Drug Delivery - Patient Controled Analgesia (CADD-PCA) pump with continuous plus on-demand dosing, contiuous dosing only or on demand doses only. In the hospital, patients often provided PCA for pain relief and management. It is always more effective to stay ahead of pain than to let it take hold and try to catch up once you are in pain. Our home infusion patients are given the same type of order if deemed necessary by their physician and they begin with a small "fanny pack" and cassette with pump. The intravenous tubing is attached to an IV site and stays hooked up until it is time to change the cassette. Rates can be changed to adjust for pain levels and it makes pain management less stressful for patients, caregivers and family.
Patients following certain surgeries may require short-term intravenous pain management in order to leave the hospital sooner than they would otherwise. For instance, post-jaw surgery when oral medications cannot be taken, or for patients who get sick from oral meds and have had knee or hip surgery. We set the patient up with their pain pump and cassette, IV fluids and anti-nausea medications to go home with and teach them how to administer everything at their home! Or a home health nurse would do the hook-up and teaching if the patient has other needs.
Narcotic pain medications can also be delivered by internally implanted intrathecal pumps. The advantages of intrathecal therapy include less sedation and fewer side effects such as constipation. These pumps are surgically placed in the abdominal cavity and are accessed through the skin. They are invisible. The pump can be felt through the skin, but you cannot see it.
For more information, see our page on Implanted Pumps
Currently Medtronic manufacturers the pump that is being implanted here in Central Oregon. The pump is called a Synchromed II pump and can hold either 20ml or 40ml of narcotic solution. A neurosurgeon places the pump under anesthesia and the patient stays in the hospital at least overnight while they recover from the surgery and see how they respond to the intrathecal dose. Sometimes the stay is a few days until things get stable, but usually patients do very well after the operation.
Having an implanted pump helps patients live more normal lives, less dependant on taking oral medications and sufferring many side effects from systemic pain management.
Implanted intrathecal pumps are highly mechanized and must be managed by a trained nurse with a specific training and equipment. A special programmer scans the pump from outside the body and takes readings of the pump's performance and programs rates and extra doses.