First, an intravenous line will be placed, generally in your hand. We will then bring you to the operating room and place several monitors on you, such as a heart, blood pressure and a pulse. These will enable us to monitor your vital signs throughout the procedure. Following placement of the monitors we will begin to give you some intravenous medication in order to decrease anxiety, as well as provide you with some pain relief.
Your back will be cleaned and the insertion point of the intrathecal port will be anesthetized with local anesthesia. The epidural needle is placed through a small incision in your back and the catheter is threaded through the needle under the guidance of X-ray. A second small incision is made on the upper part of your chest wall and a pocket is created in the tissues beneath the skin. The small circular epidural port is inserted into this pocket and connected to the catheter which is tunneled underneath the skin from you back.
The two incisions, on the chest wall and on your back, are closed with stitches and both are dressed with a sterile dressing. The port is then accessed with an access needle and connected to an external infusion pump containing the intrathecal medications. The intrathecal port will be functioning before you leave the surgical suite to provide you pain relief.
A majority of this procedure is performed under a local anesthesia, thereby providing minimal discomfort at the time of the surgery, and also providing pain relief for 6 to 12 hours afterwards. You will also receive sedation to provide optimal comfort during the procedure.