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  • AlJMark
    Participant
    AlJMark

    At my institution, peripheral nerve catheters are being managed by intermittent boluses, rather than continual infusions. A colleague has recommended that when weaning off catheters, such as Erector Spinae, for rib fractures, this should be managed by increasing the dosing interval while oral analgesics are maximised. Is there any evidence or “expert” opinion on this approach?

    #24205

    NYSORA
    Keymaster
    NYSORA

    Dear AIJMark,

    We are not aware of studies on this topic, however, our experience at NYSORA suggest that as the pain lessens, decreasing the dosing or concentration of local anesthetic while keeping the same dosing interval would be a good option before catheter removal. With erector spinae blocks, we believe that the volume could be the key to the efficacy, rather than the interval. The larger volume is more likely to result in a larger spread of the injectate, which is what is hypothesized as one of the mechanisms of action of the ESP.

    #25642
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