What are the different modes of intrathecal drug delivery?
Intrathecal drugs can be delivered in one of three modes—simple continuous infusion, “flex” dosing, or continuous infusion plus patient administered boluses. Simple continuous infusion is achieved either through peristaltic delivery or administration of sequential delivery of small microboluses, depending upon the delivery system used. “Flex” dosing is possible with the Medtronic Synchromed II intrathecal pump system, and involves a background rate of drug delivery plus periods of increased delivery that are preprogrammed to occur on a daily basis. Patient administered boluses are also possible with the Synchromed II system, and can be programmed to deliver a specific dose of drug at a specified interval and maximum doses per day.