For especially
painful procedures
— outpatient total
joint replacements
are a prime exam-
ple — the use of
continuous periph-
eral nerve blocks is
a way to extend
pain relief for
patients recovering
at home. "We have started to, depending on the case, send patients
home with a continuous nerve block catheter," says Dr. Settles. "You
can continue to infuse the local anesthetic for 2 to 5 days post-op,
depending on the infusion rate, and then the patient can remove it at
home, like a Band-Aid."
While the basic functions of pumps have stayed the same over the
years, Dr. Hickman notes that manufacturers are touting new features
that give patients better control over their pain. Both elastomeric and
electronic pumps now offer options like bolus delivery for break-
through pain and patient-controlled infusion rates. Providers can even
program some electronic pumps to begin delivering the local anes-
thetic up to 24 hours after surgery, allowing you to take advantage of
the initial block in place for surgery and extend relief.
The pumps are pretty easy to use, though they can require some
additional communication with patients pre- and post-operatively,
says Dr. Settles. "You have to do a lot of education with them on what
to expect," she says. "We also call every day post-operatively to see if
there are any problems or questions." To take some of this burden off
the facility, some manufacturers now offer services that call patients
5 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 6
• QUICKER RELIEF NSAIDs and acetaminophen delivered intravenously pack a powerful
punch compared to their oral versions.
Pamela
Bevelhymer,
RN,
BSN
