title: Continuous peripheral nerve block for ambulatory surgery.
abstract: OBJECTIVE
  Continuous peripheral nerve block (CPNB) can provide surgical anesthesia, prolonged postoperative analgesia, and acceptable side effects. Despite these advantages, CPNB is not in widespread use. Recently a new CPNB catheter system (Contiplex, B. Braun, Bethlehem, PA) was developed based on an insulated Tuohy needle, which allows for injection of local anesthetic and catheter insertion without disconnection or needle movement. At present, no clinical studies exist describing this system.
  
  
  METHODS
  Data were prospectively gathered for 1 year from 228 patients in an ambulatory surgery center. All CPNB were performed using the Contiplex system to provide anesthesia and postoperative analgesia. CPNB were performed using 5 upper and lower extremity techniques. Postsurgery local anesthetic was infused and at 24 hours, a rebolus of local anesthetic was performed. The CPNB catheter was removed and patients were examined for loss of sensation. Patients were then discharged.
  
  
  RESULTS
  Initial peripheral block was successful in 94% of patients. Failed nerve block requiring general anesthesia occurred in 6%. The catheter was patent and functional in 90% of patients at 24 hours, and 8% of patients required more than 10 mg of intravenous morphine by 24 hours postsurgery. In the postanesthesia care unit (PACU), only 4 patients (1.7%) required treatment for nausea. At 24 hours and 7 days postsurgery, no patient reported a dysesthesia.
  
  
  CONCLUSIONS
  CPNB using the insulated Tuohy catheter system offered acceptable anesthesia and prolonged pain relief postsurgery. There were few side effects. Reg Anesth Pain Med 2001;26:209-214.
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Grant
authors.forename: K C
authors.initials: KC
authors.lastname: Nielsen
authors.forename: R A
authors.initials: RA
authors.lastname: Greengrass
authors.forename: S M
authors.initials: SM
authors.lastname: Steele
authors.forename: S M
authors.initials: SM
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002404:Catheterization; D005121:Extremities / Q000294:innervation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control / Q000628:therapy; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine