The SynchroMed II pump is the latest generation of the SynchroMed pump family. It is fully implantable, programmable and automatically delivers the dose of prescribed ITB as determined and programmed by the medical team. The pump is able to accurately deliver very small, precise dosages of baclofen as a continuous infusion, a series of repeated bolus doses or as a flexible, varying continuous infusion, whichever is considered the best infusion mode to optimise the management of the child's spasticity. The pump can be painlessly adjusted an infinite number of times using the physician programmer to optimise the dose; the programming uses radio-waves to communicate with the implanted pump.

The SynchroMed II pump is powered by an internal battery which lasts approximately 7 years before it will need to be replaced. Because the battery is an integral part of the pump itself the entire pump needs to be replaced. This replacement involves a small operation requiring a brief hospital stay to replace with a new pump, the catheter normally remains and does not need replacing.

The battery life is constantly monitored by your medical team but as an added safeguard there are a number of alarms relevant to the patient that alert the medical team to the functioning of the pump, these alarms beep softly and include:

• Low battery alarm (alerts when the battery needs to be replaced)

• End-of-life battery indicator (predicts how many months of life remains)

• Low reservoir alarm (alerts when the reservoir needs to be refilled)

• Pump memory error (alerts if the pump has stopped functioning)

The pump has two options in reservoir size, either 20 or 40 millilitres which determines the thickness of the pump. The choice of size is dependent on many clinical decisions that include the size of the child and the refill frequency.

Intrathecal baclofen therapy was first licensed in the UK for spasticity of cerebral origin (including CP) in 1996.

There have been approximately 65,000 SynchroMed pump implants worldwide since the launch of the first SynchroMed pump used to deliver a variety of medications including ITB.