In this section
Indications and goals
Definition of Terms
Assessment of Equipment
Management and Physical Assessment
The use of continuous LA infusion may reduce pain and opioid requirement after surgery. It is used as part of a multimodal analgesia strategy. At the time of surgery a catheter is placed alongside a peripheral nerve or beneath the surgical incision to enable the delivery of LA directly where it is needed. Wound catheters are used currently and local anaesthetic delivered using a syringe pump colour coded yellow to identify LA. The syringe pumps are required to be programmed and the syringe refilled by nursing staff on the ward. The syringe pump is heavy and needs to be fixed to a pole which can inhibit mobility and physiotherapy.The ON-Q PainBuster® is an elastomeric pump that contains a reservoir of local anaesthetic (LA) that is infused at a constant and preset rate through a catheter that is fenestrated over 4 lengths depending on the catheter used. The soaker catheter can be placed perineurally (alongside a peripheral nerve) or under a surgical incision (wound). The PainBuster® is light and can be carried in a bag for improved patient mobility. The device cannot be refilled and the rate is fixed based on the ON-Q PainBuster® specifications.
To provide nursing staff with a standardised guideline to enable safe and appropriate care of children with a PainBuster® for post-operative pain relief.
The device is for continuous infusion of LA through a wound catheter in patients who are likely to have pain at the site of surgery eg: bone/cartilage donor sites, lower limb surgery and laparotomy. It is also used for continuous infusion of LA perineurally after upper limb or lower limb surgery where blocking a peripheral nerve’s conduction, is likely to reduce postoperative pain.
Fig1 Soaker Catheter (above)
Fig 2. The ON-Q PainBuster® (above)
Fig 3. Securing the tubing (above)
The evidence table for this nursing guideline can be found here.
Photos supplied with permission from the product specialist and trainer for ON-Q
Please remember to read the disclaimer.
development of this nursing guideline was coordinated by Sueann Penrose, Clinical Nurse Consultant, Children's Pain management Service,
and approved by the Nursing Clinical Effectiveness Committee. Updated February 2017.