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We will be giving you a local numbing medicine through a small catheter (tube) placed near the nerves that lead to the site of surgery. This medicine will help with your pain after surgery. You will likely have the catheter for 2-3 days. This handout will help to answer common questions.
The local pain medicine will not take away all your pain. You will likely still use some of the pain pills your doctor prescribed.
You will be getting a constant, set amount of numbing medicine every hour.
Most often, in about 10-15 hours, the intense numbness that you felt at first wears off and you may feel some pain. When this occurs, take some of your pain medicine and press the bolus button on the front of your pump.
Most patients describe the treated area as feeling “fat” or numb.
For an upper extremity catheter, your fingers may feel “fat.” Still, you should be able to move your fingers and have some feeling in them. They just may not feel normal to you while the catheter is in place.
For a lower extremity catheter placed in the groin, your thigh should feel numb and weak. Nerve catheters placed in the groin should not cause you to lose feeling in your toes.
Sometimes we place nerve catheters in the back of the leg near your sciatic nerve. These catheters may cause foot and toe numbness.
The infusion should be off for at least 2 hours before you remove the catheter. You should have feeling back in the treated area.
Taking out the Catheter
Wash your hands with soap and water for 15-30 seconds.
Remove the dressing. Start with the tape holding the end of the catheter that connects to the pump tubing. Loosen the tape all the way down to where the catheter is inserted.
Gently pull the catheter out. It should come out smoothly. It may get hung up where there is glue. You can loosen up this glue so the catheter can move more easily if this is the case.
If it hurts to remove it or if you feel pain down your arm or leg while it is coming out, stop and call the number listed under “Who to Call.”
The tip at the end of the catheter should be silver, blue or black. If it is not, please call.
Never cut the catheter! Never disconnect the catheter from the tubing while it is in your leg, arm or shoulder.
Throw away the tubing, the medicine bag and catheter in the trash.
Do not drive while you while you have this medicine or while you take opioid pain medicine.
If we gave you medicine to help you relax or put you to sleep, do not make important decisions until the next day. You will need to have someone with you for the first 24 hours after you go home and for most of the time you get this medicine.
While bathing, do not get the catheter, pump, or wound wet. Sponge baths work best. You will need help bathing.
Cover the catheter site with a dressing. You do not need to change the dressing unless we tell you to. Fluid may leak around the catheter. This is normal and does not mean the medicine is not working.
Avoid contact with sharp surfaces or extreme heat or cold.
Arm and Upper Extremity Catheters
Keep your arm protected while you get this medicine. Keep it in a sling except while doing physical therapy.
If you had shoulder surgery, you may notice some shortness of breath, mainly when you lie down. This may be from the medicine. It will likely go away when the medicine is done. Call your doctor and stop your pump if you are having shortness of breath.
Leg and Lower Extremity Catheters
You are at risk for falling because you have a weak leg. If you have a nerve catheter near the groin, keep your knee in a locked knee brace, while walking, for the entire time you are getting this medicine.
You must use crutches or a walker while walking around. You will not be able to support your weight without these aids.
When to Call
If you have questions or concerns about your catheter.
If the catheter disconnects from the pump or falls out.
If you have severe pain.
If the skin around the catheter gets red, painful or appears infected.
Symptoms of too much medicine (very rare):
Feel very sleepy
Have slurred speech
Tongue feels very thick
Have ringing in ears
Feel numbness or tingling around lips, tongue
Have metallic taste in mouth
Feel nervous or confused
For serious health problems (seizures, heart symptoms, loss/decreased level of consciousness), please clamp the pump and call 911 right away.
About the Pump
As you receive the medicine, the pump balloon will slowly become smaller.
If you need an MRI, please tell your doctor you have a catheter and pump.
Who to Call
Ask for the resident on call for acute pain.