The following information provides answers to some of the most frequently asked questions about home analgesia and our program.
What is an at-home catheter (home analgesia) and how does it work?
An at-home catheter is a peripheral nerve catheter that is placed near a nerve prior to surgery and remains in place after your child is discharged home. Anesthetic medication is continuously infused through this catheter to provide pain relief following surgery.
How long will it last?
We anticipate the catheter staying in place for three days. In rare instances, the catheter can become dislodged and your child may experience a loss of effectiveness of the nerve block. If you are concerned this may have happened, you will need to contact the on-call regional provider and they will assist you with troubleshooting the catheter and offer further guidance.
How will it feel?
After waking up following surgery, your child may say part or all of the affected area feels numb. This is normal. Some children even say they can’t feel that part of their body at all.
What are the benefits of a peripheral nerve block?
Because the area feels numb, your child won’t need as much opioid pain medication after the surgery. This helps to avoid the side effects of opioids, like nausea, throwing up, itching, feeling sleepy, and constipation.
Will I still need other pain medication?
Most children who get a peripheral nerve block still do take some oral (by mouth) pain medication. Motrin and Tylenol are usually recommended around the clock, and your child’s surgical team will work with the home catheter team to address any additional pain medication needs specific for your child.
What are the risks associated with an ambulatory catheter?
As with any medical procedure, home catheters have a risk of complications. These can include infection, bleeding, or local anesthetic toxicity. Watch for redness, swelling, pus or tenderness at the insertion site of the catheter, which are signs of an infection. Local anesthetic toxicity can cause dizziness, a metallic taste in the mouth, numbness around the lips, ringing in the ears, sudden anxiety or heart palpations, or seizures. If any of these symptoms should arise, the catheter tubing should be clamped and you should call us immediately at 617-355-6000 and ask to have the Acute Pain Service paged.
How do I care for my child with a catheter?
- Clamp and tubing
- Ensure the clamps of the catheter all remain open. Make sure the connections are tight and the tubing isn’t bent or kinked.
- Dressing Care:
- Keep the dressing clean and dry. Your child should not take a shower while the catheter is still in place, rather they can be given a sponge bath, ensuring the dressing stays dry and intact.
- There may be leakage at the catheter insertion site where the clear dressing is. If this happens, add more dressing (Tegaderm) and tape to the site.
- Caring for numb areas of the body:
- Protect the numb part of your child’s body from injury, as they won’t feel it as much as normal.
- Use hot and cold packs only as prescribed.If the surgery was on a leg, the leg should not bear weight while the catheter is in place. If the surgery was an upper extremity, the arm should remain in a sling.
Going home with a nerve catheter? Download our patient education sheets:
How will I remove the catheter?
Our team will schedule a telemedicine visit with you on your third post-operative day. Prior to that visit, we will send you educational materials and links of videos to watch so you know what to expect. During our telemedicine visit, we will walk you through what to do, step-by-step, to ensure an easy process. We’ll also conduct a clinical examination and answer any of your questions.