Childbirth pain, stone pain, and trigeminal neuralgia are the top pain in the minds of many people.

But in reality, there is still more pain than they have - stubborn cancer pain!

The pain makes it difficult for people to sit and stand, and the pain makes their families suffer greatly.

Many cancer patients have survived surgery, radiation and chemotherapy, but have not survived the torment of cancer pain.

Face cancer pain squarely and provide scientific pain relief. Recently, the Anesthesiology Department of Hefei BOE Hospital has implemented intrathecal analgesia pump implantation technology to install a "pain switch" for cancer pain patients, allowing them to spend time with dignity and warmth with their families, improve their quality of life, and even extend their lives.

Despite using a large amount of painkillers, lung cancer patients still feel unbearable pain

A 60 year old patient named Uncle Zhao (pseudonym) has been diagnosed with advanced lung cancer with multiple systemic metastases. Due to severe pain, Uncle Zhao cannot walk normally or lie flat, and he cannot fall asleep all night when the pain starts. As the disease progressed, Uncle Zhao switched from taking oral morphine and other drugs to intramuscular injection of morphine, accompanied by a large amount of oral analgesics, fentanyl transdermal patches, and sleeping pills.

The dosage of analgesics is increasing, but the effect is getting worse. Despite using a large amount of painkillers, the VAS pain score still reached 6 points (moderate to severe pain).

After surgery, the patient’s oral analgesic medication and intramuscular injection of morphine gradually decreased in dosage. On the third day after surgery, oral medication and intramuscular injection of morphine were discontinued, and the pain was significantly relieved.

The wound was in severe pain, but the painkillers made her vomit uncontrollably

Aunt Zhang (pseudonym), a 70 year old patient, experienced incision neuralgia after tumor surgery, which has not been relieved for two consecutive months. When I came to the hospital for treatment, although I appeared to be able to walk, sit and lie normally, my expression was painful and I didn’t say a word. Because Aunt Zhang has severe gastrointestinal reactions when taking painkillers orally, even the smallest dose of painkillers can cause frequent nausea and vomiting, leading to electrolyte imbalances and poor overall nutritional status.

The traditional "three tiered" analgesic treatment plan cannot meet the patient’s analgesic needs and has serious side effects. The fourth step intrathecal pump analgesia treatment plan has become the "killer weapon" for pain.

The pump body itself is not large and can be buried subcutaneously in the abdomen. After surgery, the incision heals and daily bathing is not a problem. After implanting the intrathecal pump, Aunt Zhang’s pain significantly improved and she was discharged 5 days after surgery.

Intrathecal pump therapy - Pain relief with a "high-speed" approach

The intrathecal morphine pump undergoes minimally invasive surgery by implanting a catheter subcutaneously, with one end leading to the subarachnoid space and the other end being implanted with a drug delivery device.

The drug is automatically continuously injected into the subarachnoid space through a drug delivery pump for 24 hours, blocking the transmission of pain signals through the spinal cord to the brain and directly acting on the pain nerve conduction pathway, thereby improving the therapeutic effect of strong analgesics such as morphine.

This approach is equivalent to implanting a miniature "drug supply station" in the patient’s body, which can inject drugs into the spinal cord through a "delivery pipeline", building a "highway" for all-weather painkillers.

Due to the direct action of drugs on the pain center, there is no need for blood circulation, and the effect is immediate. The dosage is only 1/100 of intravenous medication and 1/300 of oral medication. As long as the dosage is very small, it can have a good analgesic effect and reduce side effects. The medication can be used for several months or even a year at once when filled up. When approaching exhaustion, come to the hospital and directly inject the medication through the skin into the pump with a syringe. After filling it up, continue to use without the need for another surgery.

In addition, the intrathecal analgesic pump is equipped with an external remote control. In addition to a fixed daily injection amount of morphine, if a patient experiences severe pain, they can press the remote control and increase the injection amount appropriately to quickly control the pain. Compared to oral medication that requires digestion and absorption for at least half an hour to take effect, this remote control can manage pain faster and more effectively.

Will long-term use of intrathecal pumps lead to dependence or even addiction?

Jiao Bin, an anesthesiologist at Hefei BOE Hospital, answered: Intrathecal pump drugs act on the first site of pain convergence - the corresponding central segment of the spinal cord, with extremely low doses and concentrations of analgesic drugs. The analgesic receptors for drug dependence and addiction are mainly located in the higher central nervous system of the brain. It is difficult for small doses of drugs to spread beyond the drug’s target area. The risk of developing dependence or even addiction is much lower than that of oral analgesics.

These patients most need an intrathecal analgesic pump

l Cancer pain

Such as refractory and stubborn pain, spinal metastasis, nerve compression, visceral pain, cancerous pain syndrome, etc.

l Non cancerous pain

Herpes zoster or postherpetic pain, osteoporosis pain, lumbar postoperative syndrome (FBSS), complex local pain syndrome (CRPS), etc.

The doctor emphasized that not every patient with pain is suitable for intrathecal drug infusion treatment. Before patients choose this analgesic treatment method, doctors will conduct a cautious and systematic evaluation, and observe the patient’s response to intrathecal analgesics through testing. After confirming that the analgesic effect is good and there are no serious side effects, intrathecal pump implantation surgery can be performed.

Pay attention to pain and face it with more dignity

The implantation of intrathecal pump analgesia system is a new surgical project developed in recent years to address late stage cancer or refractory pain. It is an essential treatment method in line with the discipline construction of tertiary hospitals and an important technical indicator to measure the hospital’s technical level.

This article is reprinted from "Dingxiangyuan"

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