continuous subcutaneous infusions of analgesics

[vashtee, RN]

I hope someone can help me. I have read through my 3 drug guides, but none say where the optimal site for continuous subQ analgesic infusions would be. My textbook notes that analgesics can be given by continuous infusion by pump, but there is no additional information.

Can anyone tell me where this would infuse? I am guessing the abdomen (like an insulin pump). Also, does this type of pump work like an insulin pump? Anything you could tell me would be appreciated.

Thanks.

[iluvivt, BSN, RN]

You can administer these types of hypodermoclysis in any area where there are fat pads that will also have decent circulation. I generally use the outer tops of the thighs or lateral aspects. You can also use the abdomen. Try to find an area where it is not easily dislodged...like the buttocks. Generally these sites are rotated every 3-4 days and sometimes sooner if area is getting to large..(.absorption may be slowed). There are manufactured sets for this purpose...but if I can not locate one...it is OK to use a 22 gauge IV catheter and insert at an angle that will allow the catheter to stay in the fat. Of course,remove the needle and just leave the cannula and secure it in place. You would have to infuse this with a pump and it is generally set at a low continuous rate. In the home care setting ambulatory pumps are used.as these are small and the patient can carry them easily in a fanny pack. In a hospital setting any volumetric pump can be used as long as it can be programmed at your desired rate, Some of the hospital pumps will not allow less than 1 ml per hour unless it also allows for Pediatric calculations and rates.

[vashtee, RN]

Wow, thanks ILUVIVT! I never thought about using an IV cannula... I was thinking it was more high-tech than that.

I appreciate your help.

[iluvivt, BSN, RN]

Yes certainly OK to an IV catheter. One type of set that is desinged for this purpose is called a soft-set and has foamy pads around the needle and an extension set. The IV catheter I use is the 22 gauge 3/4th in Intima. Many years ago I used to give terbutaline this way in the home to prevent premature labor.

[vashtee, RN]

Thanks! You've been very helpful.