Elastomeric pumps for ambulatory patient controlled regional analgesia.

Purpose: To report our experience with the use of the (Eclipse(R)) elastome ric pump for ambulatory Patient Controlled Regional Analgesia (PCRA) Method: After a pilot study using this device in patients admitted to the h ospital, seven patients received PCRA at home using the elastomeric pump. P atients with a variety of continuous regional anesthetic blocks were sent h ome with written and verbal instructions regarding the use of this device, boluses, side effects of local anesthetics and removal of block catheters. Patients were contacted daily to collect data with regards to the efficacy of the block, problems associated with the use of this device and their sat isfaction with the method of analgesia. Results: During the pilot study there were two catheter disconnections requ iring rescue analgesics. Two patients had the entire contents of the bulb d elivered over several minutes. Among the seven patients receiving PCRA at h ome, one patient had to be admitted to the hospital. One patient had block catheter slip out during transit. The volume delivered could not be measure d. Patients found it difficult to know if the drug had been delivered. Thre e patients noted that the pumps were empty earlier than expected. One patie nt found it difficult to change the bulb. No patient had difficulty with ca theter removal or with bolusing. Conclusions: PCRA offers excellent postoperative analgesia at home. Elastom eric pumps facilitate PCRA but are imprecise with drug delivery and may not be safe for epidural infusions. The safety of this device for peripheral n erve blocks should be evaluated further.