Despite the focus on pain as “the fifth vital sign,” some outpatients are still going home with moderate to severe postoperative pain. This is especially true for outpatient orthopedic surgery. Single-shot peripheral nerve blocks (PNBs) can control pain, but they are time-limited by the duration of action of the local anesthetic and adjuvants. Continuous peripheral nerve blocks (CPNBs), however, can prolong pain relief well into the first postoperative day and beyond. This article will focus on the benefits of home CPNB following ambulatory surgery, what to tell naysayers who may be against a CPNB program at your institution and tips for a successful home CPNB service.

The first CPNBs were reported in 1946 by Ansbro. This study involved a series of inpatients with a needle placed through a cork and into the supraclavicular area, with rubber...

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