5 Tips for Overcoming Continuous Nerve Block Obstacles

Helpful hints for better, more successful blocks

Using ultrasound for continuous nerve blocks

Continuous nerve blocks have many distinct advantages that outweigh any drawbacks.

Continuous nerve blocks have a number of advantages for both the surgeon and the patient, but what exactly are they?

Continuous peripheral nerve blocks (CPNBs) are used in a number of surgeries that before would necessitate an overnight stay in a hospital for postoperative pain control. A surgeon places a pain catheter in the vicinity of the target nerve which acts as a conduit for the continuous flow of anesthetic. The technique provides target-specific analgesia for a variety of surgeries and gets patients through the first 48 hours after surgery with little or no pain medication.

Continuous nerve blocks decrease the time it takes for a patient to be cleared for discharge from the hospital, giving many patients the chance to return home on the same day of surgery. There’s also very little hospital readmission related to pain control associated with the procedure.

For all the advantages continuous nerve blocks have, they aren’t without obstacles. Here are five tips for surgeons to help overcome the hurdles and place successful blocks:

  1. Prepare ahead of time by placing single-shot blocks – there’s no denying it takes a lot of skill and training to place pain catheters successfully. One way to overcome the difficulty is by practicing with single-shot blocks for several months beforehand. Pain catheters are like an extension of single-shot blocks, except they’re more advanced and complex. For one, you’re using a bigger needle, most often an 18-gauge instead of a 22-gauge that’s commonly used for single-shot blocks. Practicing with single-shot blocks first will ultimately help once you’re ready for CPNBs.
  2. Use technology to your advantage – the use of continuous nerve blocks and pain catheters has become more common because ultrasound guidance has improved and become more affordable over time. Without ultrasound, catheters are very hard to place. Ultrasound makes it easier to see nerves and blood vessels, which helps to guide your needle through. Above all else, being able to see the needle at all times is essential. As you advance, you should always be able to see the tip of the needle on the ultrasound screen. This kind of visibility will help make certain you’re not damaging anything else in the process.
  3. Reimbursement comes in patient care, not monetary value – continuous nerve blocks are a huge investment for good patient outcomes. Most patients would prefer them because they allow them to leave on the same day of their surgery. With more attention on patient quality and satisfaction than ever before, CPNBs are a value-added service that can help boost those measures for your hospital.
  4. Remember: pain catheters take more time to place – even the most experienced doctor can take about 15 minutes to place the pain catheter. New practitioners may require even more time, around 30 to 40 minutes. For time efficiency, be sure to place the catheter somewhere other than the OR so you’re not wasting valuable turnover time, or worse making surgeons wait for you to begin.
  5. Manage your patient’s expectations – be sure to remind your patients that take-home pain catheters will bring their pain down significantly, but not fully. It helps with reducing postoperative pain to a more manageable level, about a four or five out of 10. By combining it with oral pain medication, pain can be reduced to around a two or three. Also remind them that the biggest problem with the catheter is not taking it out, but keeping it in. Getting one caught on something is no laughing matter. By managing patient expectations, you’ll get better results for everyone.

For more information on the advantages of using continuous nerve blocks, click here: Are Continuous Nerve Blocks Worth the Trouble?


For over 30 years, Havel’s has offered premium quality anesthesia needles and pain control needles for anesthesiologists, pain management specialists, physicians, doctors, hospitals and other leading medical professionals. To see Havel’s selection of anesthesia and pain control needles, please click here: Havel’s Anesthesia and Pain Control Needles.


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