Open Access

HOW I DO IT

How I Do It: Technical report on surgically-initiated rectus sheath catheter using catheter-over-needle assembly

Vivian H. Y. Ip¹, Jaasmit Khurana¹, Niels-Erik Jacobsen², Adrian S. Fairey², Rakesh V. Sondekoppam³

1 Department of Anesthesiology and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada
2 Division of Urology, Department of Surgery, University of Alberta Hospital, Edmonton, Alberta, Canada
3 Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA
Address correspondence to Dr. Vivian H. Y. Ip, Department of Anesthesiology and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada

Canadian Journal of Urology 2021, 28(5), 10871-10873.

Abstract

Development of chronic postsurgical pain following major abdominal or pelvic surgeries is increasingly recognized. Multimodal analgesia including regional anesthesia such as rectus sheath block is growing in popularity. While the literature mainly describes ultrasound-guided rectus sheath blocks, there are many advantages to surgicallyinitiated rectus sheath catheter performed at the end of surgery. In this technical description, we describe the rationale and technique of surgical insertion of rectus sheath catheters following major urologic surgery with midline incision which is routinely performed by urologists at our institution. Furthermore, we would like to highlight the type of catheter used during rectus sheath catheter insertion, namely the catheter-overneedle assembly. It is simple to insert while minimizes complications such as local anesthetic leakage at the insertion site causing dressing disruption and premature catheter dislodgement, as the catheter-over-needle assembly fits snugly with the skin after insertion.

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