Archive May 2018 XIX, No. 5

6 Steps to Successful Continuous Nerve Blocks

Simple pointers to increase patient — and surgeon — satisfaction.

Adam Schneider

Adam Schneider, CRNA, APRN


SUCCESSFUL BLOCKS A good nerve block gets your patients home faster — without opioids in some cases.

Nerve blocks do more than just stop pain. They decrease the time your patients spend in your facility and reduce the number of opioids they need to take post-op. Yes, there are risks that come with nerve blocks as with any procedure, but there are a number of things you can do to make sure your facility runs a successful nerve block program.

1. Surgeon buy-in

You need surgeon buy-in to your block program. Surgeons want what is best for their patients so communication is the key. It's my job, as a trained anesthetist, to show them the value nerve blocks can bring and the benefits for patient recovery. I have found that the best way to get buy-in is to approach surgeons about specific cases where nerve blocks would be appropriate, armed with the physiology of the block and evidence of the benefits to the patient. Benefits like faster discharge, lower post-op opioid use and increased patient satisfaction.

2. Patient education

Before I perform a peripheral nerve block, I like to meet with the patient personally and go over everything. I also go over all of the risks and benefits associated with the block and get informed consent. My spiel goes something like this:

Hello, my name is Adam, I am a nurse anesthetist. I will be administering your anesthetic today and will be with you every second making sure you are safe. I will be performing a nerve block for post-op pain. I will insert a needle near your nerve and inject some numbing medicine that will block the pain you would feel from the procedure. I use ultrasound so I can see where my needle tip is at all times. After the injection, I will leave a catheter in place that will give you continuous numbing medicine 24 hours a day for up to 3 days. This should take care of 60% to 90% of your pain. The rest of your pain will be controlled by other non-opioid methods. After the 3 days, you'll return to our office and the catheter painlessly slides right out.

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