OSE_1306_part2_Layout 1 6/3/13 3:41 PM Page 96
R E G I O N A L
A N E S T H E S I A
check-in, allowing for perineural catheter insertion without surgical delays.
If there is a healthcare provider who can insert perineural
catheters before entering the OR, the procedure will not delay surgical start times. Regard-less, ultrasound-guided catheter insertion
has been demonstrated to greatly reduce catheter insertion times,
compared with older insertion modalities.
The recovery room nurses should be trained to prepare and program infusion pumps and initiate infusions, as well as to provide
patients or caretakers with instructions regarding the catheter and
pump. A healthcare provider — often one of the recovery room
nurses — should call ambulatory patients daily (typically in the
morning, before the busy midday and afternoon) until catheter
removal, which may be done by patients or caretakers following
written or oral (during post-op phone calls) instructions.
Knowledge is power
Patients must understand the potential risks and benefits of
CPNBs, and act on post-op instructions to prevent untoward outcomes. For lower-extremity infusions, warn patients of the risk of
falling. Make sure patients have a thorough grasp of the following:
• how to pause the infusion pump if their toes or fingers become
completely numb (and how to restart the pump at half the basal
rate when they regain feeling in those extremities),
• how and when to adjust the basal infusion rate,
• how and when to administer a patient-controlled bolus dose,
and
• how and when to remove the perineural catheter (and dispose
of the portable infusion pump).
Always provide patients with oral instructions, written instruc9 6
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2013
