Nerve block pain control for children (1009)

What is a nerve block catheter?

A nerve block catheter is a thin tube put through the skin near a nerve. It gives medicine for pain relief after surgery. The medicine blocks the pain messages sent by the nerves to the brain.

The catheter may:

• Be used just during surgery and then taken out.
• Stay in place 1 to 4 days after surgery to give your child pain medicine. In that case, it may be:
  – removed while your child is in the hospital.
  – left in place and removed when your child goes home.

What pain medicine is used?

The most common pain medicine used is a local anesthetic called ropivacaine. It numbs only the area of the body where the surgery was done.

How much medicine will my child be given after surgery?

The anesthesiologist will order the medicine. The amount is based on the child’s weight and type of surgery.

For nerve block catheters that are left in place:

• The Acute Pain Service doctors and nurse practitioners will help to care for your child.
• Your child will have a pump that gives a continuous local anesthetic infusion of medicine every hour.
• Your child’s pain will be assessed often.
• Other medicines may be given by mouth or intravenous (IV) for your child’s pain if needed.

What are the side effects?

Some weakness, numbness, or tingling in the area affected by the nerve block is normal. Tell your nurse if symptoms are bothering your child or interfering with activity.

• If your child has a nerve block in the hip or leg, take extra safety measures to prevent falls. This includes in the hospital and at home.
  
  

Your child may have weakness or numbness at the surgery site. Please have the nursing staff and/or family help your child get out of bed or a chair, to walk, or to get dressed. Follow the surgeon’s
guidelines for moving around and activity.

• Do not put any pressure on a numb or weak area. Have your child stay away from sharp surface or extreme heat or cold. Your child could get injured from these things because he/she may not feel them.

• Less common, but possibly serious side effects include:
  -  Dizziness, lightheadedness, drowsiness, blurred vision.
  - Metallic taste in mouth.
  - Numbness around the mouth or lips.
  - Ear noises (ringing in the ears).
  - Restlessness, twitching, or tremors.
  - Skin rash or hives.
  - Seizure. If at home, call 911 immediately.

Tell your nurse or call the doctor (if you are at home) if your child has, or if you have any
questions about these less common but possibly serious side effects.

• Redness, cloudy drainage, or tenderness at the catheter site, or fever may be a sign of infection,
  tell your nurse or call the doctor if you are at home.
• Some fluid may leak from the site. As long as your child is comfortable, this is not normally a
  problem. Call the nurse (or doctor if you are at home) if there is a lot of fluid.

How is the catheter removed?

• The catheter may be removed in the hospital.
• If your child goes home with a continuous nerve block catheter and disposable pump you can remove the catheter as directed.
• Your child will feel the dressing being pulled off the skin. It will feel like a band aid being pulled off. Your child should not feel the catheter being removed.
• Even when the catheter is out, your child can get pain medicine by mouth if needed as directed by your doctor.

Remember, if your child is going home with a nerve block catheter, you should also get “Managing a
Continuous Nerve Block at Home” teaching sheet (#1062).

For other health and wellness information, check out this resource:

https://kidshealth.org/ChildrensWi/en/parents

This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.