Interscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump
S M Klein1, S A Grant, R A Greengrass
1Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA. klein006@mc.duke.edu
Anesthesia and Analgesia
|November 30, 2000
Summary
Continuous peripheral nerve blocks offer improved pain relief for outpatient rotator cuff surgery. A novel catheter system with a disposable pump provided effective, long-lasting analgesia, reducing the need for hospital stays.
Area of Science:
- Anesthesiology
- Pain Management
- Orthopedic Surgery
Background:
- Continuous interscalene brachial plexus blockade typically necessitates hospitalization for local anesthetic infusion.
- Achieving consistent catheter insertion for continuous peripheral nerve blocks can be challenging.
- A reliable catheter insertion method and self-contained infusion system are needed for short-stay surgical care.
Purpose of the Study:
- To compare the efficacy of single-injection interscalene brachial plexus blockade with a continuous peripheral nerve block using an insulated Tuohy system and disposable infusion pump.
- To evaluate the effectiveness of a continuous catheter insertion system for ambulatory pain management.
- To assess postoperative pain and opioid consumption following rotator cuff repair.
Main Methods:
- A randomized, double-blinded, placebo-controlled study involving 40 adult patients undergoing open rotator cuff repair.
- Patients received an initial interscalene brachial plexus blockade followed by a continuous peripheral nerve catheter.
- Postoperative infusions consisted of either 0.2% ropivacaine or normal saline at 10 mL/h via a disposable infusion pump for 24 hours.
Main Results:
- The ropivacaine group experienced significantly less pain between 12 and 24 hours post-injection compared to the placebo group (P = 0.0001).
- The continuous catheter insertion system demonstrated a high success rate for initial blockade and catheter function.
- All catheters were functional after 24 hours, indicating reliability in the ambulatory setting.
Conclusions:
- Continuous peripheral nerve blockade with a novel catheter insertion system and disposable infusion pump is feasible for ambulatory settings.
- This approach facilitates successful catheter placement and provides effective analgesia for outpatient procedures.
- This method offers potential for improved pain management after outpatient rotator cuff repair, potentially reducing hospital stays.
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