Upper Extremity Peripheral Nerve Block Catheters - Home Care
You are getting a local anesthetic through a small tube (also called a catheter) placed near the nerves that go to your arm and shoulder. This medicine should help with your pain after surgery. The catheter has been placed by your anesthesia doctor at the request of your surgeon. This sheet will help to answer common questions.
About this Type of Pain control
Most often, the local pain medicine will not take away all of your pain. You will take the pain pills prescribed by your doctor while you have the catheter in place.
- We need to be in contact with you to make this treatment work. Your anesthesia doctor will call you the evening after your surgery and each day you have your catheter in place.
- It is important we speak to you each day to make sure you are doing well. We may need to make changes to your treatment.
- If you have not been contacted on any day that your catheter is in place, page or call the block doctor at the number below.
Call Doctor ______________________________ at (608) 262 -0486. Give your name and phone number with the area code to the paging operator. The doctor will call you back.
You will be getting about a teaspoon of numbing medicine constantly every hour. You can also give yourself more 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 20 minutes after pressing the bolus button, you should take your oral pain medicine as prescribed.
- Most often, in about 10-15 hours, the intense numbness that you felt at first wears off. You may feel some pain. Take your pain medicine and press the bolus button on the front of your pump. The bolus gives you a small amount of extra numbing medicine.
- 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 may not feel normal to you while the catheter is in place.
- If you are getting physical therapy (PT) while you have your catheter, press your bolus button 30 minutes before your PT session.
- The catheter is most often kept in place for 3-4 days.
- When it is time to take the catheter out, we will take you through the process over the phone. The pump should be turned 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, follow these steps.
- Remove the dressing.
- Gently pull the catheter out.
- Note the metal coil tip or blue tip at the end of the catheter (the part that was under your skin).
- Tell the doctor or nurse on the phone what the tip looks like.
- If the catheter does not come out easily, tell us. We will have you do things differently. If it hurts to remove the catheter or if you have sensations down your arm or hand while the catheter is coming out, STOP. Tell the doctor or nurse on the phone what you are feeling.
- Never Cut The Catheter!
Instructions
- Do Not Drive while you are getting this medicine.
- 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 a small amount of shortness of breath, mainly when you lie down. This may be from the medicine. It will likely go away when the treatment is over. Tell your doctor 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.
- Clear or pinkish fluid can leak from around the catheter where it goes into the skin. This is normal and does not mean the medicine isn’t working.
- If the skin around the catheter gets red or painful, call the block doctor.
Things we worry about
It is very unlikely that you will receive too much medicine. However, if you do get too much medicine, it might make you feel unusually sleepy and drowsy. Your speech might slur. Your tongue might feel very thick or numb. You might feel nervous or confused. If you have any of these symptoms, stop the pump and clamp the tubing as you were taught and call your block doctor right away.
If you start to feel numbness on the opposite arm, stop the pump and clamp the tubing and call your doctor right away.
About the pump
- You will know the pump is working because you can see a blinking green Run light and the volume infused will display.
- When the catheter has been removed, the entire pump will be returned by placing it in the UPS envelope. This will be picked up at your home on day 4 after surgery. UPS will not pick-up on Saturday or Sunday. The pick-up will occur on the next business day. The mailing label will be generated at the time of pick-up. Please dispose of the drug in the garbage. The pack is yours to keep.
I have reviewed these instructions with a doctor or acute pain nurse.
Date_________
Patient’s Signature________________________________
Doctor’s Signature______________________________
*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: 07/27/2010
Copyright © 07/27/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6870
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