For patients with infraclavicular peripheral nerve catheters, injection of saline through the needle instead of local anesthetic during placement may be associated with lower pain scores: a retrospective chart review:
The efficacy and effectiveness of peripheral nerve catheter placement for preoperative pain control is clear and their numerous benefits have been outlined before. Placement of peripheral nerve catheters is easier and safer than it ever has been. However, even with the advancement in technology and equipment, there remains a level of failure once the initial block recedes. Often times, this may be due to dislodgment, which is unavoidable at times. However, postoperative catheter failure may also be due to initial improper placement. A prior study at our institution evaluating postoperative analgesia in patients with inter scalene catheters and its association with whether local anesthetic was injected through the needle prior to the catheter v. through the catheter after precise placement was confirmed using saline, suggested patients with local anesthetic through the catheter have improved analgesia. This is a continuation of that study, and we too hypothesize that injecting local anesthetic through the catheter for infraclavicular blocks only after proper placement of the catheter is confirmed with saline may be associated with better analgesia and lower rate of block failure.