Since I use stimulating catheters, I've been bolusing through the catheter in order to confirm localization of the distal tip of the catheter next to the nerve via nerve stimulation. However, this may hypothetically pose a problem: by bolusing through the catheter, say 20-30 ml of local anesthetic, the nerve would be pushed away from the distal tip of the catheter. Hence, this may theoretically decrease the likelihood of a successful secondary block with the continuous infusion of the local, since the nerve is now further away from the distal tip due to the bolus.
Bolusing may help with the primary block and may result in a nice, prolonged block but in order to maximize the success of a secondary block, I wonder if I should just run a continuous infusion at a high rate (e.g., 8-10 ml/hr).
Do you guys tend to bolus through the Touhy or the catheter? Or do you bolus at all (for postoperative analgesia, not surgical aneshesia)?
Bolusing may help with the primary block and may result in a nice, prolonged block but in order to maximize the success of a secondary block, I wonder if I should just run a continuous infusion at a high rate (e.g., 8-10 ml/hr).
Do you guys tend to bolus through the Touhy or the catheter? Or do you bolus at all (for postoperative analgesia, not surgical aneshesia)?
