Medically Reviewed By
Dr. Kailash KothariMD Anesthesiology, Pain Medicine, FIAPM (Pain Medicine) · 30+ years experience
- No surgery required for many conditions
- Same-day procedures
- International training & advanced techniques
What is an implanted epidural portal?
An implanted epidural portal is a small drug-delivery device used to manage severe, long-standing pain. A thin catheter is placed into the epidural space — the area surrounding the spinal cord and nerve roots — and connected to a small port that sits just under the skin. Pain medication, such as a local anaesthetic or opioid, can then be delivered directly into the epidural space by passing a fine needle through the skin into the port.
Because the medicine is delivered close to where pain signals travel, smaller doses are often effective and patients may have fewer of the side effects seen with high-dose oral medicines. The portal also avoids the need for a fresh spinal injection on every visit, which makes repeated treatment far more comfortable for patients who need frequent epidural medication.
At Pain Clinic of India, the device is placed using image guidance and strict sterile technique by an interventional pain specialist. It is most commonly used for intractable cancer pain, but may be considered in selected patients with other severe chronic pain after careful assessment.
Who is Implanted Epidural Portal for?
- Intractable cancer pain not controlled by oral or transdermal medicines
- Severe chronic pain requiring frequent epidural medication
- Patients who need repeated epidural injections over weeks or months
- Patients in whom oral opioids cause unacceptable side effects
- Selected patients with chronic non-cancer pain after specialist assessment
How Implanted Epidural Portal is performed
- A thin epidural catheter is placed into the epidural space under fluoroscopic (X-ray) guidance
- Correct placement is confirmed with a small amount of contrast dye
- The catheter is tunnelled under the skin to a small port (reservoir) placed in a pocket on the chest or abdominal wall
- The port sits just beneath the skin and can be felt but is not visible
- Medication is later given by inserting a fine needle through the skin into the port, avoiding repeated spinal punctures
Before, during & after the procedure
Before: A clinical assessment, review of imaging and a trial of epidural medication are usually done first to confirm the approach will help. Blood-thinning medicines are adjusted, infection is ruled out and informed consent is taken.
During: The procedure is performed under strict sterile conditions with image guidance and local anaesthetic, often with light sedation. The catheter is positioned in the epidural space and connected to the subcutaneous port. Radiation exposure is kept to a minimum.
After & recovery: Patients are observed for a short period and the port site is checked for healing over the following days. Once healed, medication can be delivered through the port at the clinic or, where appropriate, by trained carers. The site is kept clean to reduce infection risk.
Benefits of Implanted Epidural Portal
- Allows repeated epidural medication without a fresh spinal puncture each time
- Delivers medicine close to the source of pain, so lower drug doses are often effective
- Can reduce the side effects associated with high-dose oral opioids
- Improves comfort and quality of life in severe cancer and chronic pain
- Minimally invasive and reversible — the device can be removed if no longer needed
Risks & possible side effects
- Soreness or bruising at the port site for a few days
- Infection at the skin pocket or, rarely, in the epidural space (minimised by sterile technique)
- Catheter blockage, kinking or displacement requiring adjustment
- Post-dural-puncture headache (uncommon)
- Bleeding (rare, especially if blood thinners are managed correctly)
Conditions treated with this procedure
Frequently asked questions about Implanted Epidural Portal
Medical references
This page is informed by guidance from the following authoritative medical sources: