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ANESTHESIA ALERT
PRACTICAL PEARLS
ment, and surgeons
and patients become
more familiar with the
superior pain relief it
provides. Femoral
nerve catheters have
helped convert anterior cruciate ligament
surgery to the outpatient setting, and sciatic/ popliteal catheters
have let ankle fracture
and podiatric patients
go home immediately
after surgery.
But with the
increasing use of
lower extremity
CPNB come additional risks — along with
an increased risk of
infection comes the
very real risk of
patient falls. The
increased risk of
infection is the result
of catheter placement
in less-visible, lessclean and less-dry
5 Tips for CPNB Success
I
mplementing outpatient CPNB can be daunting.
However, under the right circumstances, the benefits (decreased pain, fewer opioid side effects,
eliminated admissions, shortened discharge times,
decreased costs and increased patient and surgeon
satisfaction) outweigh the risks. These 5 tips may
require a little extra time and/or expense, but they can
help ensure success and prevent readmission, or
worse:
1. Select patients who can be counted on to understand and take necessary precautions and to follow
through on instructions.
2. Educate patients (and family or friends) and reiterate instructions both before and after surgery.
3. When possible, use ultrasound to facilitate placement.
4. Use liquid adhesive to prevent infections and
catheter leaks.
5. To prevent falls and further injuries, make sure
patients with lower extremity CPNB have knee
immobilizers and patients with upper extremity
CPNB have arm slings.
— Jerome M. Adams, MD, MPH, & Ryan D. Nagy, MD
S E P T E M B E R 2013 | 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
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