Going Home with an Upper Extremity Catheter
You are getting a local anesthetic through a small tube placed near the nerves that go to your arm or shoulder. This medicine will help with your pain after surgery. The catheter (tube) has been placed by your anesthesia doctor at the request of your surgeon. This sheet will help to answer common questions.
The local pain medicine will not take away all of your pain. We expect that you will use some of the pain pills prescribed by your doctor while you have the catheter in place.
- You will be getting about a teaspoon of numbing medicine constantly every hour. You can also give yourself extra medicine by pushing the “bolus” button at the front of the pump. You can press the button as often as you want. It will only give you the extra medicine once every 30-60 minutes based on the way your doctor programmed your pump. If you still have pain after 20 minutes, you should take your oral pain medicine as agreed.
- Most often, in about 10-15 hours, the intense numbness that you felt at first wears off and you may feel some pain. When this occurs take some of your pain medicine and press the bolus button on the front of your pump.
- After time the strongest part of the nerve block goes away. Most patients describe their fingers as feeling “fat”. Still, you should be able to move your fingers and have some feeling in them. They just may not feel normal to you while the catheter is in place.
- The catheter is most often kept in place for 2-3 days.
- When it is time to take the catheter out, we will take you through the process over the phone. The infusion should be off for at least 2 hours before you remove the catheter. You should have feeling back in your hand and arm.
To remove the catheter, you will follow these steps.
1. Remove the dressing.
2. Gently pull the catheter out.
3. Note the tip at the end of the catheter.
4. Tell the doctor or nurse how the tip looks.
5. If the catheter does not come out easily, please tell us. We will have you do things in a different way. If it hurts to remove the catheter or if you have sensations down your arm or in your hand while the catheter is coming out, STOP. Let the doctor know that you are having these feelings.
6. Never Cut The Catheter!
Instructions
- Do Not Drive while you are getting this medicine.
- If sedation was used prior to the catheter placement, do not make important personal or business decisions until the next day.
- You will need to have someone with you for the first 24 hours after you go home and for most of the time you are getting this medicine.
- Keep your arm protected while you are getting this medicine. It should be kept in a sling except while doing PT.
- If you have had shoulder surgery you may notice some small degree of shortness of breath, mainly when you lie down. This may be from the medicine. It will likely go away when the medicine is done. Call your doctor and stop your pump if you are having shortness of breath.
- While bathing do not get the catheter, pump, or wound wet. Sponge baths work best. You will need help to bathe.
- Fluid may leak around the catheter. This is normal and does not mean the medicine is not working.
- If the skin around the catheter gets red or painful, call the doctor.
Things we worry about
It is very rare that you will receive too much medicine. However, if you were to get too much medicine, it might make you feel unusually sleepy. Your speech might slur. Your tongue might feel very thick. You might feel nervous or confused. If you feel any of these symptoms stop the pump or clamp the tubing and call your doctor right away.
If you start to feel numbness on the opposite arm, stop the pump or clamp the tubing and call your doctor right away.
About the pump
- You will know the pump is working because you can hear a series of clicking noises and see the number for the “amount delivered” increase.
- When the catheter has been removed, please be sure the pump is returned in the mail with the cap in place. If you can’t get this in the mail please bring the pump back to clinic.
TO REACH YOUR DOCTOR:
CALL 262-2122 and ask to have Dr.___________ paged. If no one answers then ask to speak to the resident on acute pain call.
*Adapted from Shands/University of Florida “Patient Instructions: Upper Extremity Catheters” 4/3/07
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 03/28/2013
Copyright © 02/20/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6870
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