Epidural block (Catheter and port or pump implant)

What is an epidural block (Catheter and port or pump implant)?

The temporary stopping or decreasing of the pain transmission in the nerves with the drugs given into the cerebrospinal fluid is called spinal analgesia. Drug administration into the cerebrospinal fluid can be performed with the help of a spinal needle for single-dose applications or with the help of a spinal catheter for long-term analgesic treatment.

Continuous spinal analgesia with opioids applied intrathecally is a method preferred especially in the treatment of pain in terminal stage cancer patients.Intrathecal opioids (morphine) applied by placing permanent port - pump systems in the treatment of localized cancer pain create analgesia by binding to opioid receptors located at the level of the posterior root.

How is a spinal port catheter placed?

The patient is placed on the fluoroscopy table in the lateral position. The place where the intervention will be made in the lumbar region is wiped sterile and covered. With the control of fluoroscopy (device that provides imaging by using X rays), the area where the intervention will be made is displayed. Spinal protrusions at the level of intervention are determined and entered with the appropriate needle between the two protrusions. When the spinal area is entered in accordance with the technique, the suitability of the place is checked with fluoroscopy. A catheter is inserted through the needle, whose tip is in the spinal gap, and placed in this area, and the needle is removed and the catheter is left in the spinal area. A subcutaneous tunnel is opened and the other end of the catheter is advanced subcutaneously through this tunnel up to the anterior axillary line. A surgical incision is made in the skin, the port system (drug reservoir) is attached to the end of the catheter and the skin is sutured again and the procedure is terminated.

Who can get a spinal port catheter?

In patients with chronic pain, when adequate analgesia and quality of life cannot be achieved with traditional treatments, interventional treatments should be applied. Continuous spinal analgesia with opioids administered intrathecally is preferred especially in terminal stage cancer patients.

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