femoral nerve blocks for post-op pain?!

[scootermcnutt, RN]

I've had several patients with femoral nerve blocks post-op lateley. One was a one-time injection with the port left in, the other was a continuous drip on a pump. Anyone know of any special care or hints? Also, is removing these catheters a nursing task?

[P_RN, ADN, RN]

Mighty late finding this question. We didn't have femoral blocks where I worked. They might be doing them now for all I know though.

We did a LOT of continuous epidural and intrathecal pain management. We also had the intrascalene blocks for arms and shoulders. I would advise looking at the policy manual and the nurse practice act to check about removing the catheters.

Our place was allowing all RNs to do it, but the State Board of nursing gave an advisory opinion that intrathecal caths were not within the scope of practice. WE (RNs) refused to do it then and finally the pain service stopped doing them. They got tired of having to come monitor and remove them.

Have you had any formal training in monitoring these? We had 8 hours of class and were required to pass a test and be observed doing each of the procedures before we were listed as qualified. Those pumps are quite complicated.

The bulb type "pain buster" infusion sets are being used some. The greatest danger in either type is the catheter breaking off inside the patient. Not a happy circumstance to be in.

[PAKRHMC]

We use Femoral Nerve Blocks on many of our TKR's. They work really well for anterior knee and thigh pain . They don't help Posterior knee pain so the docs usually also order a PCA . Anesthesia is responsible for removing them and they also check the patient each day while it is in. We use continuous pumps. The nurse needs to check sensation to the leg for numbness. While some is expected it should not be excessive. The patients must have assistance OOB , which they need anyway.