4
Pumped up recoveries
The ability of continuous local anesthetic infusion pumps to
deliver highly effective motor-sparing sensory anesthesia to the
knee for about 3 days has played a significant, even revolutionary, role
in letting surgical facilities offer total joint replacements on an outpa-
tient basis. Pain pumps contribute a measure of follow-through to
your pain management plans.
Following surgery, the patient is connected to the pump via the
peripheral nerve catheter that anesthesia placed during pre-op prepa-
rations. The pump automatically and continuously delivers a regulat-
ed flow of non-narcotic local anesthetic for precisely targeted pain
relief in the days following surgery.
While the pump's effects are fairly straightforward, don't neglect
patient education in the post-op stage. PACU nurses should thorough-
ly review how the pump works, what to expect during its operation,
and how patients can interact with it to control their pain through
adjusting the flow rate or delivering bolus doses if necessary.
For the first 3 days after they're discharged, patients receive daily
check-in phone calls from our nursing staff, in addition to visits from
the home-care nurse and physical therapist, to ensure they're progress-
ing in their recoveries. Patients also have 24-hour phone access to their
anesthesiologist during this period in the event they have any questions
about their pain or our post-op pain management regimen.
5
Constant improvement
Both large and small elements of these pain management meas-
ures — from the block methods you employ, to the technology
with which you implement them, to the skills of individual members
of your care team — will have a huge impact on overall patient out-
2 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
