Ambulatory perineural local anesthetic infusion

Abstract

Single-injection regional nerve blocks generally are limited in providing postoperative analgesia by their duration of 12 to 16 hours or less. The use of a perineural catheter to infuse local anesthetic allows for postoperative analgesia after the initial regional blockade has resolved. The relatively recent introduction of small, portable infusion pumps has allowed this technique to be used in the ambulatory setting. Although this form of analgesia offers significant improvements in pain control after many procedures, multiple factors such as patient education and close follow-up evaluation must be accounted for to provide safe and effective continuous nerve blocks at home. This article reviews important issues related specifically to ambulatory perineural local anesthetic infusion, including indications, exclusion criteria, issues of catheter placement, patient education, discharge criteria, patient follow-up, potential complications, documentation, catheter removal, and infusion pump selection. Copyright 2003, Elsevier Science (USA). All rights reserved.