Table of Contents Author Guidelines Submit a Manuscript
The Scientific World Journal
Volume 2014, Article ID 572507, 9 pages
http://dx.doi.org/10.1155/2014/572507
Research Article

The Cleveland Clinic Experience with Supraclavicular and Popliteal Ambulatory Nerve Catheters

1Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue, E-31, Cleveland, OH 44195, USA
2Anesthesiology Department, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0531, USA
3Anesthesiology Department, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3272, USA
4CCLCM of Case Western Reserve University, Cleveland Clinic, 9500 Euclid Avenue, E-31, Cleveland, OH 44195, USA
5Anesthesia and Outcome Research, Department of General Anesthesia and Pain Management, Cleveland Clinic, 9500 Euclid Avenue, E-31, Cleveland, OH 44195, USA
6Outcome Research Department, Anesthesia Institute, Cleveland Clinic, 9500 Euclid Avenue, E-31, Cleveland, OH 44195, USA
7Pain Management Department, Anesthesia Institute, Cleveland Clinic, 9500 Euclid Avenue, E-31, Cleveland, OH 44195, USA

Received 25 December 2013; Accepted 20 January 2014; Published 2 April 2014

Academic Editors: T. Grau and S. Lang

Copyright © 2014 Ramez Gharabawy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Continuous peripheral nerve blocks (CPNB) are commonly used for intraoperative and postoperative analgesia. Our study aimed at describing our experience with ambulatory peripheral nerve catheters. After Institutional Review Board approval, records for all patients discharged with supraclavicular or popliteal catheters between January 1, 2009 and December 31, 2011 were reviewed. A licensed practitioner provided verbal and written instructions to the patients prior to discharge. Daily follow-up phone calls were conducted. Patients either removed their catheters at home with real-time simultaneous telephone guidance by a member of the Acute Pain Service or had them removed by the surgeon during a regular office visit. The primary outcome of this analysis was the incidence of complications, categorized as pharmacologic, infectious, or other. The secondary outcome measure was the average daily pain score. Our study included a total of 1059 patients with ambulatory catheters (769 supraclavicular, 290 popliteal). The median infusion duration was 5 days for both groups. Forty-two possible complications were identified: 13 infectious, 23 pharmacologic, and 6 labeled as other. Two patients had retained catheters, 2 had catheter leakage, and 2 had shortness of breath. Our study showed that prolonged use of ambulatory catheters for a median period of 5 days did not lead to an increased incidence of complications.