Complications of intrathecal drug delivery systems and drugs used

Intrathecal drug delivery systems (IDDS) are devices used to provide continuous infusion of a drug into the intrathecal space via a sialastic catheter strategically placed in the cerebral spinal fluid of the neuroaxis. The Polyanalgesic Consensus Conference best practices and guidelines, in conjunction with the SAFE principles, help guide the decision-making process when considering IDDS for treatment. This chapter includes discussions of the indications for IDDS, technical approaches with pictures, potential complications, and strategies for preventing complications. Pump-related complications include pump rotation or flipping in the pocket, overfilling, mechanical pump failure, and battery failure. Prevention includes creating an appropriately sized pocket and anchoring the pump with four non-absorbable sutures. Overfilling the pump can lead to failure because of the increased pressure placed on the IDDS.