Name of the Procedure:

Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (injection catheter placement)

Summary

Injection catheter placement involves inserting a thin, flexible tube (catheter) into a vein. This catheter is used to administer diagnostic or therapeutic substances continuously or intermittently. These substances may include anesthetics, antispasmodics, opioids, steroids, or other solutions but exclude neurolytic substances.

Purpose

This procedure is used to deliver medications or diagnostic agents directly into the bloodstream continuously or in controlled bursts. It helps manage conditions like chronic pain, muscle spasms, inflammation, and other disorders that benefit from direct medication delivery. The goal is to provide effective symptom relief or facilitate diagnosis while reducing the need for repeated needle sticks.

Indications

• Chronic pain requiring long-term medication
• Severe muscle spasms not responsive to oral medications
• Need for continuous or controlled administration of opioids or anesthetics
• Inflammatory conditions needing direct steroid injections
• Diagnostic testing requiring prolonged agent delivery

Preparation

• Follow fasting guidelines provided by the healthcare provider (often required for anesthesia).
• Stop specific medications as instructed, particularly blood thinners.
• Undergo necessary blood tests or imaging to assess veins and overall health status.

Procedure Description

1. Preparation: The patient may be given a sedative or anesthesia to ensure comfort.
2. Insertion: The healthcare professional cleans the insertion site with an antiseptic solution.
3. Placement: Using ultrasound guidance, a small needle is inserted into a suitable vein, usually in the arm or neck.
4. Catheter Insertion: A thin catheter is threaded through the needle into the vein.
5. Securing: The catheter is secured in place with adhesive dressings and may be connected to an infusion pump for continuous or intermittent delivery of medication.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Interventional radiologist or anesthesiologist
• Trained nurses
• Sometimes a pain management specialist or surgical technician

Risks and Complications

• Infection at the catheter site
• Bleeding or bruising
• Accidental dislodgement of the catheter
• Allergic reactions to medications used
• Rarely, blood clots or air embolism
• Pain at the insertion site

Benefits

• Effective pain management or symptom control
• Direct delivery of medication reduces systemic side effects
• Avoids the need for repeated needle sticks
• Can be used for both diagnostic and therapeutic purposes

Recovery

• Immediate post-procedure monitoring for any adverse reactions
• Keep the catheter site clean and dry
• Follow instructions for catheter maintenance
• Avoid heavy lifting or strenuous activities as advised
• Regular follow-up appointments to assess the catheter and adjust treatments

Alternatives

• Oral or intravenous medication administration
• Implantable pain pumps
• Nerve block injections
• Physical therapy or alternative pain management techniques

Pros and cons:

• Oral meds are less invasive but may be less effective for severe symptoms.
• IV meds require repeated needle sticks.
• Implantable pumps require a surgical procedure to place.

Patient Experience

During the procedure, patients might feel slight pressure or discomfort at the insertion site. Post-procedure, some soreness is expected, but pain management measures will be discussed. Patients should feel relief from their symptoms within a few days to weeks, depending on the medications used. Regular follow-up ensures continued effectiveness and addresses any concerns.