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Patient survey of continuous interscalene analgesia at home after shoulder surgery
Elie J Chidiac1, Roland Kaddoum, Steve A Peterson
1Wayne State University, Detroit, Michigan, USA.
Background:
The use of continuous peripheral nerve blocks at home (CPNBH) has improved patients' perioperative experience. In 30 months, 348 patients were sent home with interscalene CPNBH.
Methods:
With the Institutional Review Board (IRB) approval, all patients were surveyed for quality of analgesia and complications. The patients and their caretaker received verbal and written instructions, including care of the catheter and pump, and a list of complications and side effects. All were instructed on catheter removal and were given a contact number, and patients were called once per day.
Results:
172 patients responded to this survey. The majority of patients (76%) had very good postoperative analgesia. There was a 9.3% incidence of leakage of clear fluid, a 5.8% incidence of premature dislodgement, and an 8.7% incidence of shortness of breath. Residual neurological symptoms persisted in 18.6% of responders, all resolving within two months except in one case. A large proportion (40%) required no oral analgesics, and half of the rest required less than 3 pain pills. Most (94.1%) felt comfortable removing the catheters at home by themselves or by a family member/caretaker.
Conclusion:
This survey shows that CPNBH results in low pain scores and a low incidence of side effects. Many patients commented positively on their overall impression of their anesthesia care, particularly the level of attention that they received. This highlights the low incidence of those complications and neural injury.
