What is a Continuous Catheter Nerve Block?
Continuous Catheter Nerve Blocks Performed by Las Vegas, Summerlin, and Henderson Nevada’s Top Pain Doctors
Continuous catheter nerve blocks provide extended pain relief through the placement of a catheter in the skin near peripheral nerves. The catheter is attached to a small, portable container containing pain medication. The purpose of this procedure is to provide a continuous supply of analgesic medication to help relieve pain.
Continuous catheter nerve blocks, also frequently called continuous peripheral nerve blocks, were initially reported in case reports in 1946. Since then, the procedure has drastically evolved from early case reports of a needle inserted through a cork taped to a patient’s chest to a well-tested and clinically acceptable analgesic technique.
How Is a Continuous Catheter Nerve Block Performed?
Prior to the procedure, the patient’s skin is cleaned in preparation for the injection. If sedation is needed, it will be delivered through an IV and vital signs such as blood pressure, heart rate, and breathing will be monitored. The physician then uses an anesthetic to numb the skin. Next, the physician uses nerve stimulation with ultrasound or twitch-monitor to guide the needle to the correct nerve.
Once the correct nerve is found, the catheter is threaded through the needle along the nerve sheath. The doctor then withdraws the needle and the catheter remains in place in its tunneled position. Liquid adhesive and a bandage are placed at the catheter site to hold it in place and a small portable container is connected to the bandage. The container contains medication, which will be continually infused through the catheter for pain relief. The entire procedure takes about 15 minutes.
The documented benefits of continuous catheter nerve blocks highlight their effectiveness in reducing the need to take large doses of oral pain medication, resulting in fewer side effects. One study found that in a post-operative setting, the use of continuous catheter nerve blocks instead of opioids reduced the incidence of nausea and vomiting by 65% to 81%, improved patient’s moods, decreased hospital stays, and increased nightly sleep by up to two hours.
Other investigations have revealed that continuous catheter nerve blocks dramatically decrease patient pain levels in chronic pain conditions. They have also proven useful in palliative (end-of-life) care situations, such as terminal cancer. These studies have also revealed that continuous catheter nerve blocks provide patients with end-stage cancer the opportunity to spend less time in the hospital and more time with their family and friends.
Continuous catheter nerve blocks are considered safe, non-invasive procedures; however, as with all procedures, there is some risk of complications. Although rare, potential risks include catheter dislodgement, fluid leakage, skin irritation, bleeding, nerve damage, and infection.
Conditions Related To a Continuous Cather Nerve Block
The extended administration of pain medicine remains one of the greatest challenges after a painful surgery. According to research published in Anesthesiology Research and Practice, approximately 50% to 70% of patients suffer moderate-to-severe pain after surgery. Despite the incidence of pain, patients are now being discharged quicker than in the past.
In addition to post-operative pain, continuous catheter nerve blocks are successfully used in ambulatory outpatient pain clinics.
This gives patients the much-needed opportunity to have effective pain therapy in their homes. Continuous catheter nerve blocks have proven to be useful for a variety of conditions, such as:
- Complex regional pain syndrome
- Post-amputation pain
- Back and neck pain
- Cancer-related pain
- Phantom limb pain
- Peripheral embolism
- Trigeminal neuralgia (chronic pain syndrome)
- Herpetic neuralgia
- Brachial plexus neuropathies
- Pain control for aggressive post-operative physical therapy
In today’s medical environment, there is a growing emphasis on shorter hospital stays and an increased shift toward the convenience and effectiveness of outpatient surgery and care. In this capacity, continuous catheter nerve blocks allow the pain-relief benefits of anesthesia to be extended beyond the typical eight to twenty hours attained through a single injection.
Continuous catheter nerve blocks are a conservative option for treating a variety of chronic, painful conditions. This well-established nonsurgical treatment has been the subject of many studies that have shown favorable results concerning its safety and efficacy. It remains a sound substitute for oral opioids and other prescription pain medications. Continuous catheter nerve blocks also allow patients the opportunity to return home quicker after surgery and allow for highly-effective pain relief in an outpatient setting.
- Aguirre J, Del-Moral A, Cobo I, Borgeat A, Blumenthal S. The role of continuous peripheral nerve blocks. Anesthesiology Research and Practice. 2012;7:1-11.
- Capdevila X, Ponrouch M, Choquet O. Continuous peripheral nerve blocks in clinical practice. Curr Opin Anesth. 2008;21:619-623.
- Ilfield B, Loland V, Sandhu N, Suresh P, Bishop M, et al. Continuous femoral nerve blocks: The impact of catheter tip location relative to the femoral nerve (anterior verse posterior) on quadriceps weakness and cutaneous sensory block. Regional Anesthesia. 2012;115(3):721-727.
- McLeod G. Peripheral nerve catheter techniques. Anesth Int Care Medicine. 2010;11(3):109-110.
- Pacenta H, Kaddoum R, Burgoyne L. Continuous tunneled femoral nerve block for palliative care of a patient with metastatic osteosarcoma. Anaesth Intensive Care. 2010;38(3):563-565