We are able to offer patients undergoing upper and lower extremity surgery that meets certain criteria a ‘home’ nerve catheter to extend analgesia for a minimum of 48 hours after discharge.
Patient criteria:
• Need to stay within a 3h driving distance from the Holland Orthopaedic and Arthritic Centre.
• Patients staying in a hotel are NOT candidates, but ok if they stay with family or friends.
• Needs to be able to follow instructions re troubleshooting and removal of nerve catheter.
• Need to have family/friend staying with them while catheter is insitu.
• Willing to bear responsibility for managing the nerve catheter.
Process in POP clinic:
• This option is mentioned to patients meeting above criteria in the pre-assessment clinic when obtaining verbal consent for a peripheral nerve block.
• The patient guide contains information re this method of extending analgesia.
Process on day of surgery:
• The attending anesthesiologist on the day review this option with the patient prior to administering any sedation.
• Bolus nerve catheter as usual in block area (no need to start infusion before end of surgery).
• Fill ‘baby bottle’ (see instructions in block area re. dilution) and attach to nerve catheter in either PACU or SDA
• Complete the progress note (form kept at the block room computer) to enable follow up and leave in block area at computer. Make sure we have a contact number where we can actually reach the patient or family; their home number is no help if they will stay elsewhere !
• Postop order: "Start 0.2% Ropivacaine at 5ml/hr to continue on dicharge home"
• Inform APS NP re patient (text Eri @ 647.654.0887)
Follow up of patients with a home nerve catheter:
• Daily phone calls as long as catheter is in situ (including day of removal).
• Patients will be provided with APS on call pager number - this will be their contact in case of any concerns/questions
• Complete the progress note and leave in block area or email to Eri.
The following is the pamphlet provided to patients with ambulatory nerve block catheter.
The following is the pre-printed progress note for ambulatory catheter follow up.
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