CONTROLLING PAIN: Using regional blockade for adjunct pain relief

November 2004 
Volume 34  Number 11
Pages 74 - 75
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  • How the system works

  • Patient-care pointers



  • Figure. No caption a...

    REGIONAL ANESTHESIA techniques such as continuous incisional blockade or continuous femoral and interscalene blockade provide good pain relief immediately after surgery for patients undergoing certain painful procedures (for example, abdominal surgery or total joint replacement). While the blockade is working, the patient won't need opioids or a patient-controlled analgesia (PCA) pump.

    The disadvantage of short-term regional blockade is that it wears off quickly, resulting in a dramatic increase in pain intensity that may not be covered in time by opioid administration. The good news is that several types of disposable pumps have been developed to deliver regional blockade that lasts days instead of hours. Used as an adjunct to opioid pain management, this therapy is appropriate in patients who are candidates for regional anesthesia blockade, including patients with large abdominal incisions, some plastic surgery patients such as those who've had breast reconstruction with flap use, and patients who've had shoulder surgery or knee replacement.

    Research indicates that regional blockade improves a patient's ability to function while reducing his need for opioid pain medications. This allows him to be discharged promptly and to participate sooner in rehabilitation.

    How the system works

    A disposable pump controls a continuous infusion of local anesthetic into either the surgical wound (for example, a large abdominal incision) or along the sheath of a nerve, such as the femoral nerve (for patients who've had total knee replacement). To provide a broad area of numbness around a surgical incision, the surgeon threads a soaker catheter (one with multiple perforations) into the incision and secures it with a transparent dressing. ...

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