Bois Bernard Private Hospital
Making appointments: 03 21 79 26 56
Secretariat: 03 21 79 26 36
Est-ce-que ça fait mal?
Je rentre à la maison le soir de mon opération.
"On m'a branché un petit cathéter au bas du cou relié à un dispositif électronique" c'est une analgésie continue...
Votre anesthésie se poursuit à la maison.
Un Professionnel de santé va venir vous rendre visite chez vous.
Votre infirmière est une Pro. Elle va gérer ce cathéter
This page is dedicated to Healthcare Professionals
Space professional
of the nurse
Shoulder Surgery is generally performed under general anesthesia.
Our team of anesthesiologists masters the latest loco-regional analgesia techniques.
Anesthesia is completed with an Inter-Scalenic Block (BIS)
When performing this BIS, a micro-catheter is placed in contact with the nerve roots.
This catheter is connected to a pre-programmed electronic diffuser
which allows the administration of ROPIVACAINE
Catheter management perineural
At home
For the Nurse: a must read
ROPIVACAINE delivery protocol
The pumps are set to a rate of 5ml/h without bolus
You will have to make a change of ROPIVACAINE bag of 2 mg/ml of 200ml on D+1 in the evening during your visit. To do this you will need to:
Empty the new ROPIVACAINE bag with the help of the intravenous line set provided.
Pause the pump by pressing the rectangular button (top)
Disconnect the old bag of ROPIVACAINE and connect the new one in which you have just emptied.
Press the rectangular “play/pause” button (at the top). The pump is running.
On D+2 in the evening, during your visit, you remove the catheter having first turned off the pump (OFF position by turning the base down)
Monitoring tables
Independent nurse information and supervision
Principle of the Peri nervous catheter:
Analgesia of a painful area by injection in the local anesthetic (ROPIVACAINE 2mg/ml) by means of a catheter positioned near a nerve or a nervous plexus.
This catheter is connected to a pump which diffuses continuously throughout the day.
It is placed in the operating room after skin preparation according to department protocol.
Home nursing supervision:
Daily monitoring by the private nurse of the various operating parameters (monitoring table), the effectiveness of the device, the tolerance of the drug administered and an assessment of the pain.
The removal of the catheter and the device is done at the end of the treatment, i.e. the morning of D+3
Assessing the effectiveness of analgesia:
Normal signs reported by the patient: "cottony" skin, numbness that tingles and slight heaviness in the (painful) territory of the chosen block
Pain assessment with ENS (simple numerical scale) or VAS (visual analogue scale)
Monitoring of sensory block and motor block
What to do in case of failure:
Notify the service provider who can approach the prescriber to find out what to do.
Monitoring of inflammatory and/or infectious signs:
Redness, oedema, discharge, pain, displacement of the catheter, leakage by reflux of local anesthetic at the puncture site, hematoma...
The dressing should be clean, dry, occlusive and transparent.
In the case of postoperative analgesia, there is no need to change the dressing. But if necessary, a Tegaderm-type dressing must be put back on top of the dressing in place.
What to do: monitor the temperature. Notify the service provider who will contact the anesthetist for a possible prescription for bacteriological sampling and removal of the catheter to be cultured or for a possible immediate return to the hospital.
Monitoring for side effects or incidents of overdose
Paresthesias at the extremity of the affected limb
Tingling sensation and two tingling in the fingers. This is a common side effect is completely normal, reassure the patient vis-à-vis this phenomenon.
Potential side effects without consequences:
Metallic taste in the mouth
Lip paresthesias
Nystagmus (low amplitude oscillation of the eyes)
BERNARD-HORNER syndrome:
Minimal sagging of the upper eyelid and slight sinking of the eyes into the sockets. If these disorders appear: Warn the service provider, reassure the patient, this syndrome is completely reversible and has no consequences.
Extremely rare effect but to know: respiratory distress.
Indrawing and Dyspnea
Stop the device immediately and notify the service provider
Perineural catheter ablation protocol
Install the patient in the supine position, slightly inclined if possible
Perform simple hand washing
Remove the bandage
Hand disinfection by friction using an alcoholic hydro solution
Disinfect the area according to the Betadine four-step protocol
Remove the catheter (if a request for culture has been requested: cut the end of the catheter and put it in the bacteriology bottle)
Put on a bandage to prevent infection or discharge
Perform simple hand washing
Anesthesia-resuscitation center
Technical platform
The technical platform is the entire structure dedicated to surgery. The operating block includes 12 intervention rooms, a recovery room, an intensive care unit, and post-surgical resuscitation.
This technical platform complies with the most recent safety standards.
Anesthesia medical team
All the conditions are met for your anesthetic safety. Six experienced anesthetist-resuscitators work as a team to ensure that your operation takes place in optimal safety. Anesthetist-resuscitators also provide postoperative resuscitation and pain management in our facility.
They master the most recent loco-regional anesthesia techniques. In addition to your conventional anesthesia (general anesthesia), it brings you post-operative comfort through additional anesthesia. pain control is assured.
pain control
Post-operative
But also at your home
Along with performing the surgery, your anesthesiologist positions a small catheter (a few tenths of a millimetre) ( A ) allowing the distribution of an anesthetic product. The analgesia continues at your home thanks to a small programmed electronic pump ( B ).
This technique brings many advantages:
pain control
Decrease in edema
Reduced risk of reflex sympathetic dystrophy
Immediate rehabilitation
Immediate return home
Home support
Analgesia by perineural catheter
Analgesia by perineural catheter allows the continuous diffusion of anesthetic in contact with a nervous structure.
The Interscalene Block
Ultrasound-guided interscalene block (BIS) consistently blocks the C5-C6 nerve roots, producing reliable anesthesia and analgesia of the shoulder and arm.
Ultrasound-guided interscalene block of the brachial plexus provides deep surgical anesthesia and postoperative analgesia for shoulder surgery.
Common side effects of BIS include transient paralysis of the diaphragm and recurrent laryngeal nerve. These side effects are generally well tolerated.
Patient selection is particularly important to ensure the safety of interscalene block, which is frequently associated with transient phrenic nerve palsy. This paralysis can induce significant respiratory distress in patients with pre-existing respiratory disease.
Your Anesthesiologist will accompany you to choose the best analgesia.
( B ) Electronic diffuser
