CONTINUOUS NERVE BLOCKS

What is a continuous nerve block?

This is a technique where a small plastic tube connected to a bag and a pump delivers a slow trickle of local anaesthetic fluid to the area around the nerves. Usually a single injection nerve block lasts ~8-16 hours but with this technique pain relief can be provided for several days. The device is fully portable and battery operated and can be taken home once you have received education on how to manage it. 

How is it delivered?

The local anaesthetic tube (catheter) is connected to a lightweight portable fully disposable pump. It pumps ~5-6mls of local anaesthetic fluid per hour continuously 24h per day. Occasionally additional top-up bolus options are available. Your anaesthetist will discuss this with you if it is an option. The number displayed on the mini-screen is the total volume delivered over time.

What do I need to do?

There is very little to do. You need to be careful not to dislodge the catheter. You may notice that the catheter insertion site may become damp from local anaesthetic fluid leaking back. This can cause the dressing to lift and become loose or fall off. If you notice a leak but the dressing is stable and the nerve block is effective there is no need to do anything other than possibly adding another dressing on top to seal the leak. If the leak increases or the dressing becomes loose the dressing may need changed but this is not common. Occasionally the catheter will fall out in which case a simple band aid can be placed over the site and the pump and tubing disposed of into the bin.

How long does it run for?

Depending on the type of surgery it may be scheduled to run for 2, 3 or even up to 5 days. You will be told how long your infusion is prescribed for. The reservoir bag is usually 200 or 400mls and once it runs out the pump will alarm and the infusion will cease. At this point simple turn off the pump by twisting the knob at the base to 'OFF'. 

How is it removed?

• Wash your hands thoroughly with soap and warm water. Dry thoroughly.
• Remove the dressing covering the catheter site.
• Remove any skin adhesive strips.
• Grasp the catheter close to the skin, and gently pull on the catheter. It should be easy to remove and not painful. Do not tug or quickly pull on the catheter during removal. If it becomes hard to remove or stretches,then STOP. Call your doctor. Continued pulling could break the catheter.

• Do not cut or pull hard to remove the catheter but there is some skin glue at the insertion site which may need to be picked off the skin to loosen the catheter

Once removed simply put the whole unit in the bin. It is fully disposable.

 

There is a video link above relating to a similar catheter and pump which displays how to remove the dressing from the skin and how to pull out the tubing.

© MJLennon FANZCA

Affiliated with The Joint Studio

 Hollywood Medical Centre

Suite 1, 85 Monash Avenue

Nedlands

Western Australia 6009