Nerve Catheters For Surgery

Information for Patients and Families

General Information

What is a nerve catheter

Nerve catheters consist of a thin, flexible tube placed near the targeted nerve(s). Local anaesthetic medication is delivered via the catheter to continuously numb the nerves for several days. Compared with a nerve block, which is a single injection of local anaesthetic, this method allows for a continuous delivery of pain relief.

How does it work?

Nerve catheters are inserted as part of a nerve block procedure. Once positioned close to the targeted nerve(s) using an ultrasound, the needle is removed, leaving only the catheter behind.

The catheter is then secured in place on your skin and connected to a specialised pump. This pump continuously delivers a controlled amount of local anaesthetic medication through the catheters, bathing the nerves to provide sustained pain relief.

What are the risks and complications of a nerve catheter?

A nerve catheter carries similar risks to a nerve block. (see nerve block section)

However, the additional risks with a catheter include:

Catheter malfunction: the catheter can accidentally dislodge or become obstructed, leading to the interruption of local anaesthetic infusion and inadequate pain relief.
Infection: there is an increased risk of infection as a catheter is left behind. Sterile techniques are used to place the catheter. Proper care and monitoring of the catheter site minimise this risk.
Local anaesthetic systemic toxicity: this is when too much local anaesthetic drug enters the bloodstream.

How do you use it?

The local anaesthetic in the pump can be given in a few different ways, depending on how it was set up. Here are the possible options:

The pump can automatically provide a continuous infusion or a bolus of local anaesthetic
You may also have the option to use a patient–controlled button, allowing you to self-administer a small additional local anaesthetic if you experience pain.

Your anaesthetist or your recovery nurse will explain exactly how your nerve catheter and pump work.

Post-operative

Care

Advice for it's use

Do not change the pump settings on your own
Keep the insertion site and catheter equipment clean and dry
Take care of the affected numb area
If a nerve catheter is for your arm, it should be supported with a sling
If a nerve catheter is for your leg, ensure you have some accompany you when walking

What happens next?

A nerve catheter will usually stay in place for 2 to 5 days. Once inserted, the area where you have had the operation will feel numb, heavy, warm and tingly.

Once the medication has run out, you can remove your nerve catheter following the instructions provided by our anaesthetist.

Removal of Catheter

Take off the dressing covering the catheter site.
Grasp the catheter near the skin and gently pull on the catheter.
The catheter should come out easily and without pain.
If it becomes difficult to remove or stretches, then STOP and Contact your doctor.
Once the catheter is removed, inspect the catheter tip for the black marking to confirm the entire catheter has been removed.
Apply a bandage over the catheter sit

Once the catheter is removed or the local anaesthetic infusion has stopped, it will take several hours for the sensation and movement to return to normal. You may need to start taking oral pain medications as prescribed.

Starting pain relief medications

Your surgical team or anaesthetist will prescribe the following medications based on the type of surgery you underwent and your specific needs. Begin taking these medications once the infusion has concluded and the catheter has been removed.

Regular Medications:

Paracetamol: Take this regularly once the infusion has ceased.
Anti-inflammatory drugs (e.g., celecoxib, voltaren, ibuprofen): Take these regularly along with paracetamol.

As-Needed Medications: Take the following medications if you require additional relief beyond the regular medications:

Tramadol: Effective for moderate to severe pain.
Opioids (e.g., Severdol/Oxynorm): Use as needed for more pronounced pain.

Always follow the prescribed dosage and instructions provided by your healthcare provider. If you have any concerns or experience adverse effects, contact your healthcare team promptly

Things to look out for

An SMS text follow-up is sent to patients who have received a nerve block and catheter. If you have any non-urgent concerns, reply yes to the text message, and an anaesthetic doctor will give you a call to follow up.

It is important to seek urgent medication attention promptly if

There are signs of infection - redness, swelling, and warmth around the insertion site.
You have symptoms of Local anaesthetic systemic toxicity (LAST) - metallic taste, tingling in the lips, blurred vision, dizziness, confusion, seizures, and palpitations.