OS_1310_part2_Layout 1 10/7/13 10:26 AM Page 58
R E G I O N A L
A N E S T H E S I A
timodal analgesia regimen.
We're all pretty familiar
with the reasons to consider CPNBs in the outpatient
setting (see "Making the
Case for Continuous
Nerve Blocks" on page 40),
but what about the keys to
INFECTION PREVENTION To prevent infections
successfully administering
related to continuous nerve blocks, use a skin
antiseptic and create a sterile field with towels or drapes.
them? This month we give
our list of 8 tips for placing CPNBs. Though not exhaustive, taking
this list into account will go a long way toward ensuring success while
minimizing delays and complications.
1. Choose the right patient
This is perhaps the most important step to help avoid trouble with
CPNBs. You are inserting a foreign device that can cause infection,
nerve injury or local anesthetic toxicity. Patients must comprehend
instructions and warnings from both a language and an educational
standpoint. You should feel you can trust the patient to maintain insertion site integrity, change pump settings if appropriate and to alert you
of concerns. The patient must also have realistic expectations in
terms of placement, maintenance and analgesia.
2. Choose the right surgeon
You and the surgeon should be on the same page before proceeding with
a CPNB, including understanding the time it will take to place the block,
the degree and duration of analgesia expected, and common problems
that may occur (for example, quadricep weakness with a femoral
CPNB). A surgeon who expects pain scores of 0, or who doesn't know
5 8
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 | O C T O B E R 2013
