Name of the Procedure:

Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances

Summary

This medical procedure involves inserting an indwelling catheter to facilitate continuous or intermittent delivery of medications or diagnostic substances. The substances administered can include anesthetics, pain relievers, steroids, or muscle relaxants. It does not encompass the use of neurolytic substances, which destroy nerve tissue.

Purpose

This procedure is used for managing various medical conditions that require direct and sustained delivery of therapeutic or diagnostic agents. Goals include effective pain management, reduced muscle spasms, inflammation control, and diagnostic evaluations.

Indications

• Chronic pain conditions such as cancer pain or severe arthritis
• Muscle spasms or spasticity
• Need for prolonged delivery of medications like anesthetics or pain relievers
• Diagnostic purposes requiring continuous monitoring or delivery of contrast agents

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Necessary adjustments to current medications, especially blood thinners.
• Pre-procedure diagnostic tests like blood work, imaging studies, or allergy assessments.

Procedure Description

1. The patient is positioned comfortably, and the skin at the insertion site is cleaned.
2. Local anesthesia is administered to numb the area.
3. A small catheter is inserted into a vein or tissue space.
4. The catheter is securely placed to allow for continuous infusion or intermittent bolus of the chosen substance.
5. The catheter is connected to an infusion pump or injection system.
6. The infusion or injections are administered according to the treatment plan.

Tools, Equipment, or Technology Used:

• Catheter
• Infusion pump or injection system
• Sterile gloves, drapes, antiseptic solutions
• Local anesthetic

Anesthesia or Sedation Details:

• Local anesthesia is typically used; sedation may be considered for anxiety management or if required by specific patient conditions.

Duration

The procedure itself typically takes about 30 minutes to one hour, depending on complexity.

Setting

The procedure is generally performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Physicians or interventional specialists
• Nurses
• Anesthesiologists (if sedation is used)

Risks and Complications

• Infection at the catheter site
• Bleeding or bruising
• Allergic reactions to the administered substances
• Catheter displacement or blockage
• Rarely, systemic complications like blood pressure changes or respiratory problems

Benefits

• Effective management of chronic pain or spasticity
• Targeted delivery of medications with potentially fewer systemic side effects
• Enhanced diagnostic accuracy for certain conditions

Recovery

• Monitoring for a short period after the procedure to ensure stability
• Instructions on catheter care and management
• Regular follow-up appointments to adjust medication dosage or monitor for complications
• Expected recovery time is minimal, though ongoing care for the indwelling catheter is necessary.

Alternatives

• Oral or intravenous medications
• Transdermal patches
• Short-term injections
• Surgery or nerve blocks for certain cases
• Pros and cons vary; alternatives may offer less precision in delivery or more systemic side effects.

Patient Experience

• Patients may feel a pinch or pressure during catheter insertion.
• Mild discomfort at the insertion site can be managed with local anesthetics or pain relievers.
• Continuous monitoring and support from healthcare professionals to manage any discomfort during and after the procedure.