Methods and apparatus for administering local anesthetic
Apparatus for administering certain nerve blocks includes a sheath constructed from a flexible ultrasound echogenic material, a more rigid introducer/dilator for introducing the sheath into the patient, and an ultrasound echogenic catheter for inserting through the sheath once the distal end of the sheath is in place adjacent the nerve(s) to be blocked and the introducer/dilator has been withdrawn. The catheter has provisions at its proximal end for connecting to a source of local anesthetic. Methods for use of this apparatus are also described.
1. A method for administering a peripheral nerve block to a patient, the method comprising:
penetrating the body of the patient with a first needle to form a tunnel, wherein a distal end of the first needle emerges from the body of the patient at a predetermined marked site,
placing a first sheath over the distal end of the first needle,
withdrawing the first needle from the first sheath, wherein the first sheath is partially pulled through the tunnel made by the first needle,
inserting a first catheter having a proximal end and a distal end through the partially withdrawn first sheath until the first catheter reaches an opposite end of the tunnel,
removing the first sheath,
introducing a second needle sheathed within a second sheath having a proximal end and an open distal end through which a distal end of the second needle projects into the body of the patient at the predetermined marked site,
advancing the sheathed second needle into the tunnel until the sheathed second needle reaches a nerve bundle to be blocked,
delivering local anesthetic,
withdrawing the second needle, wherein the distal end of the second sheath is adjacent the blocked nerve bundle,
inserting the distal end of the first catheter into the proximal end of the second sheath,
advancing the distal end of the first catheter down the second sheath to the location of the blocked nerve bundle, and
removing the second sheath, wherein the first catheter forms a loop extending from the predetermined marked site, wherein the loop is pulled back through the tunnel by pulling on the proximal end of the first catheter, and
connecting the proximal end of the first catheter to a source of local anesthetic, and
commencing anesthesia via the first catheter.
2. The method of claim 1 further comprising providing a stimulating clip adjacent a proximal end of the second needle for coupling the second needle to a peripheral nerve stimulator to facilitate passing a current through the second needle and the patient's body to stimulate nerves in the area of the distal end of the first second needle.