REGAIORRNOAWL ARNEAGEIOSNTHALE SAINA APERSOTDHUECSTIAS IncreaseNdu slalafnet yu tapnadt, cvoumlpfuotrpt aftoier uesreor d aionnd uplaptuietnatt 2 REGIONAL ANAESTHESIA AND PAIN MANAGEMENT Regional anaesthesia allows for reduced patient stress and greater economy and is gaining more and more in importance. Whether it be peripheral nerve blocks, spinal anaesthesia, epidural anaesthesia or a combination of these, we can provide you with a complete instrument range for any technique in all areas. Advanced instru- ments employing cutting-edge technology assure the highest possible safety, comfort and economic benefits. Regional anaesthesia helps to lessen the risk of cardiovascular and pulmological complications. Operating theatre waiting times are reduced, and as patient stress is kept to a minimum, recovery is faster and the waiting list becomes shorter. REGIONAL ANAESTHESIA – SAVES TIME AND COSTS, AND ENHANCES PATIENT COMFORT WHERE DOES IT HURT? Pain is a natural warning sign. Without pain we could put ourselves in danger. Pain is part of our lives and bodies. Yet if it is not treated properly, pain can disable us. Pain requires a solution, treatment, and respect. If there is no natural way to deal with pain, we need the help of instruments, tools and medical support. Regional anaesthesia is a tool that helps control pain during and after surgery. REGIONAL ANAESTHESIA AND PAIN MANAGEMENT AND HOW OUR PRODUCTS FIT INTO THIS PROGRAMME: Wherever it hurts, your primary concern is to relieve your patient’s pain, whether it’s acute, surgical or chronic. Without effective regional anaesthesia and post-operative pain management, your patients will recover more slowly. Effective pain management will lead to increased trust in you and your department. Our Arrow and rüsch products, along with others such as the ambIT PCA pump, can offer you specific support for regional anaesthesia and pain management. WE ARE THE PERFECT TEAM FOR YOUR PATIENT’S PAIN MANAGEMENT – YOU CAN RELY ON US LATEX-FREE: PHTHALATE-FREE: LATEX All products in this catalogue are free of latex. PHTHALATE All products in this catalogue are phthalate-free. PVC-FREE: PVC CE MARKED: All products in this catalogue are free of PVC. All products in this catalogue have the CE marking. CATHETER MR CONDITIONAL: MR Conditional Advisory INTRODUCTION 3 SPINAL ANAESTHESIA rüsch Spinostar .................................................................... 4 EPIDURAL ANAESTHESIA rüsch Epistar ........................................................................ 6 Arrow FlexTip Plus .............................................................. 8 COMBINED SPINAL / EPIDURAL ANAESTHESIA rüsch Epistar CSE .............................................................. 10 PERIPHERAL NERVE BLOCK ANAESTHESIA Arrow FlexBlock ..................................................................12 Arrow StimuCath ............................................................... 14 Arrow UltraQuik ................................................................ 16 Arrow StimuQuik .............................................................. 17 PAIN MANAGEMENT ambIT PCA Pump ............................................................... 18 RÜSCH BASIC SET ............................................................. 19 ARROW SELECT KITS ....................................................... 20 ACCESSORIES ................................................................... 21 INDEX ..................................................................................23 4 spINal aNaEsTHEsIa SPINAL ANAESTHESIA RÜSCH SPINOSTAR CANULAS Take a look at the optimised tip design of our Spinostar Pencil Point Opti with an opening as far forward as possible, yet still big enough for the continuous discharge of drugs. Spinostar Pencil Point Opti Or, alternatively, check out our Spinostar BallPen. With its new tip design the needle only penetrates as deeply as abso- lutely necessary, and you can feel a clearly noticeable “click” when the needle has reached the correct position. Also on offer is our Spinostar Standard needle which has proven itself in practice over many years. Spinostar Ballpen Spinostar Standard SPINOSTAR BALLPEN: STEP 1: INTRODUCING THE NEEDLE When introducing the spinal needle, the stylet closes the central opening. The needle penetrates the dura with a noticeable “click” and minimal tissue trauma. STEP 2: THE STYLET IS WITHDRAWN As soon as the needle is placed correctly, the stylet is withdrawn, leaving the central opening unobstructed. There is then no need to advance the needle any further. STEP 3: BACKFLOW OF FLUID PROVIDES CONFIRMATION The fluid flows swiftly and directly through the central opening and confirms the position is correct. spINal aNaEsTHEsIa 5 COLOUR CODE The size-specific colour coding of SpinoStar spinal needles prevents mistakes. 19 G 22 G 24 G 25 G 26 G 27 G SPINOSTAR PENCIL POINT OPTI REF. pRODUCT DEsCRIpTION QTY 190120-090220 Spinostar spinal needle 22 G 90 mm + Introducer needle 19 G 30 mm 25 190120-090240 Spinostar spinal needle 24 G 90 mm + Introducer needle 20 G 30 mm 25 190120-090250 Spinostar spinal needle 25 G 90 mm + Introducer needle 21 G 30 mm 25 190120-090260 Spinostar spinal needle 26 G 90 mm + Introducer needle 21 G 30 mm 25 190120-090270 Spinostar spinal needle 27 G 90 mm + Introducer needle 22 G 30 mm 25 190120-105220 Spinostar spinal needle 22 G 105 mm + Introducer needle 19 G 30 mm 25 190120-105240 Spinostar spinal needle 24 G 105 mm + Introducer needle 20 G 30 mm 25 190120-105250 Spinostar spinal needle 25 G 105 mm + Introducer needle 21 G 30 mm 25 190120-105260 Spinostar spinal needle 26 G 105 mm + Introducer needle 21 G 30 mm 25 190120-105270 Spinostar spinal needle 27 G 105 mm + Introducer needle 22 G 30 mm 25 190120-120220 Spinostar spinal needle 22 G 120 mm + Introducer needle 19 G 38 mm 25 190120-120240 Spinostar spinal needle 24 G 120 mm + Introducer needle 20 G 38 mm 25 190120-120250 Spinostar spinal needle 25 G 120 mm + Introducer needle 21 G 38 mm 25 190120-120260 Spinostar spinal needle 26 G 120 mm + Introducer needle 21 G 38 mm 25 190120-120270 Spinostar spinal needle 27 G 120 mm + Introducer needle 22 G 38 mm 25 INTRODUCER REF. pRODUCT DEsCRIpTION QTY 190190-030190 Introducer needle 19 G 30 mm 25 190190-030200 Introducer needle 20 G 30 mm 25 190190-030210 Introducer needle 21 G 30 mm 25 190190-030220 Introducer needle 22 G 30 mm 25 SPINOSTAR STANDARD REF. pRODUCT DEsCRIpTION QTY 190110-090190 Spinostar spinal needle 19 G 90 mm 25 190110-090220 Spinostar spinal needle 22 G 90 mm 25 190110-090250 Spinostar spinal needle 25 G 90 mm 25 190110-090270 Spinostar spinal needle 27 G 90 mm 25 SPINOSTAR BALLPEN REF. pRODUCT DEsCRIpTION QTY 190140-090220 Spinostar spinal needle 22 G 90 mm + introducer needle 19 G 30 mm 25 190140-090240 Spinostar spinal needle 24 G 90 mm + introducer needle 20 G 30 mm 25 190140-090251 Spinostar spinal needle 25 G 90 mm + introducer needle 21 G 30 mm 25 190140-090271 Spinostar spinal needle 27 G 90 mm + introducer needle 22 G 30 mm 25 190140-120250 Spinostar spinal needle 25 G 120 mm + introducer needle 21 G 38 mm 25 190140-120270 Spinostar spinal needle 27 G 120 mm + introducer needle 22 G 38 mm 25 6 EpIDURal aNaEsTHEsIa EPIDURAL ANAESTHESIA RÜSCH EPISTAR SETS Two sizes, one optimum system. Our EpiStar offers you two- fold benefits. The needle has a small 18 G outer diameter, while the Epistar catheter has an interior lumen the same size as that of a standard 16 G catheter. THE 16/18-PRINCIPLE: MORE FOR LESS reduced puncture reduced flow trauma with 18 G resistance due needle to large lumen catheter EpIDURal aNaEsTHEsIa 7 EPISTAR SETS REF. sET sIzE pRODUCT DEsCRIpTION QTY 190210-000180 Mini set • Tuohy needle 18 G 8 cm, catheter 19 G 90 cm 25 • Tuohy Borst adapter 190220-000180 Midi set • Tuohy needle 18 G 8 cm, catheter 19 G 90 cm 25 • Tuohy Borst adapter, flat filter 0.22 µ 190230-000180 Maxi set • Tuohy needle 18 G 8 cm, catheter 19 G 90 cm 10 • Tuohy Borst adapter, flat filter 0.22 µ • 10 ml LOR Luer slip syringe 190231-000180 Maxi set • Tuohy needle 18 G 8 cm, catheter 19 G 90 cm 10 • Tuohy Borst adapter, flat filter 0.22 µ • 10 ml LOR Luer lock syringe 190240-000180 Maxi set • Tuohy needle 18 G 8 cm, catheter 19 G 90 cm 10 • Tuohy Borst adapter, flat filter 0.22 µ • 10 ml LOR Special Luer slip syringe 8 EpIDURal aNaEsTHEsIa DISTAL FLASHBACK WINDOW Two flashback windows in the catheter body permit easy visualisation of blood or cerebral spinal fluid upon aspiration. SOFT DISTAL TIP Unique distal tip design helps to reduce the risk of vascular cannulation and paraesthesia. 1.2. ARROW FLEXTIP PLUS NOW AVAILABLE WITH A CLOSED DISTAL TIP AND Designed to reduce complications in the epidural space, for 4 LATERAL EYES adults as well as for children (caudal and lumbar procedures). Improved fluid aspiration and drug administering Excellent kink-resistance and tensile strength coupled with a soft, flexible tip reduce the risk of paraesthesia and the inadvertent penetration of blood vessels or the dura, that can misdirect the delivery of anaesthetics.1.2. Simpler and faster epidural procedures are facilitated by the catheter’s unique coil-reinforced body. The structural integrity of this design provides resistance to collapsing and requires no stylet for insertion (exceptional for caudal procedures in children). Catheter radiopacity is enhanced by the inner spiral-wound stainless-steel coil body construction. CATHETER MR CONDITIONAL 1 Junega M, MD, Kargas GA, MD, Miller D, CRNA, Perry E, MD, Gupta B, MD, Pajel V, MD, Botic Z, MD, and Rigor B, MD. Comparisons of Epidural Catheters Induced Paresthesia MR Conditional Advisory: Non-clinical testing has demonstrated the device to be in Parturients. Poster presentation from the American Society of Regional Anesthesia MR Conditional. Under specific conditions, a patient with this device can be scanned safely immediately after placement. More detailed information regarding the use of (A.S.R.A.) meeting: presented April, 1995 – Orlando, FL. Regional Anesthesia 1995; 20 this device in an MR environment is available upon request from ARROW. (Suppl.):4. 2 Junega M, MD, Kargas GA, MD, Miller D, CRNA, Perry E, MD, Botic Z, MD, and Rigor B, MD. Incidence of Epidural Vein Cannulation in Parturients with Three Different Epidural Catheters. Regional Anesthesia 1996; 21 (Suppl.):4. EpIDURal aNaEsTHEsIa 9 FLEX TIP PLUS REF. pRODUCT pRODUCT DEsCRIpTION vE • epidural needle 17 G 9.84 cm TW with cm markings • FlexTip Plus catheter 19 G 90 cm FlexTip Plus JC-05400-E • SnapLock adapter 20 epidural catheter • flat filter 0.22 µ • 7 ml LOR special Luer slip syringe • Tuohy needle 17 G Pajunk 8.50 cm • FlexTip Plus catheter 19 G 90 cm FlexTip Plus JC-05400-B • SnapLock adapter 20 epidural catheter • flat filter 0.22 µ • 10 ml LOR special Luer slip syringe • Tuohy needle 17 G Unisis 9 cm • FlexTip Plus catheter 19 G 90 cm FlexTip Plus EU-05400-BU • SnapLock adapter 20 epidural catheter • flat filter 0.22 μ • 10 ml LOR special Luer slip syringe • Tuohy needle 17 G Pajunk 8.57 cm • FlexTip Plus catheter 19 G 90 cm FlexTip Plus UM-05400-B • SnapLock adapter 20 epidural catheter • flat filter 0.22 µ • 10 ml LOR Luer Lock syringe, omnifix • Dull Hustead needle 17 G 9.84 cm FlexTip Plus • FlexTip Plus catheter 19 G 90 cm EC-05400-E 20 epidural catheter • SnapLock adapter • flat filter 0.22 µ • Super Dull Crawford needle 18 G 5 cm Paediatric FlexTip Plus • FlexTip Plus catheter 20 G 90 cm with stylet EC-05420-P epidural catheter • SnapLock adapter 20 caudal • flat filter 0.22 µ • 10 ml LOR special Luer slip syringe FlexTip Plus • FlexTip Plus catheter 19 G 90 cm EC-05500 20 epidural catheter • SnapLock adapter • Dull Tuohy needle 18 G Pajunk 5cm Paediatric FlexTip Plus • FlexTip Plus catheter 20 G 90 cm EC-05520-P epidural catheter • SnapLock adapter 20 lumbar • flat filter 0.22 µ • 10 ml LOR special Luer slip syringe • Tuohy needle 17 G 9 cm • FlexTip Plus catheter 19 G 90 cm • SnapLock adapter • flat filter 0.22 µ FlexTip Plus UR-05501 • 10 ml LOR syringe 10 epidural catheter • table drape and fenestrated drape • extra syringes and needles • gauze pads 10 x 10 cm • swab sticks for use with disinfection procedure • epidural needle 17 G 9.84 cm TW with cm markings • FlexTip Plus catheter 19 G 90 cm FlexTip Plus • distal tip with four lateral holes JC-05400-DC 20 epidural catheter • SnapLock adapter • threading assist device • flat filter 0.22 μ • epidural needle 17 G 9.84 cm TW with cm markings • FlexTip Plus catheter 19 G 90 cm • distal tip with four lateral holes FlexTip Plus JC-05400-DCS • SnapLock adapter 20 epidural catheter • threading assist device • flat filter 0.22 μ • 10 ml LOR special Luer Slip syringe THERACATH REF. pRODUCT pRODUCT DEsCRIpTION QTY EC-05000 Theracath epidural catheter Theracath epidural catheter 19 G 90 cm with SnapLock adapter 20 10 COMBINED spINal / EpIDURal aNaEsTHEsIa COMBINED SPINAL / EPIDURAL ANAESTHESIA RÜSCH EPISTAR CSE SETS The EpiStar CSE Tuohy needle is the ideal way of combining two techniques, offering an optimal procedure for a reliable combined epidural/spinal anaesthesia. Catheter and spinal needle are introduced into the patented EpiStar CSE Tuohy needle at the same time. The shape of the needle, which is still only 18 gauge, prevents the catheter from being damaged by the spinal needle and ensures secure insertion of both components. CSE TECHNIQUE First place the needle in the epidural space as usual. Then, without any rush, insert the catheter through the needle into the epidural space. Finally insert the spinal needle through the EpiStar CSE needle and into the subarachnoid space. STEP 1: EPIDURAL ANAESTHESIA Handling of the CSE needle is identical to that of a normal epidural needle. STEP 2: INSERT EPIDURAL CATHETER THROUGH CSE NEEDLE The test dose gives information about the correct catheter position. For this procedure the epidural catheter must be introduced prior to performing the spinal anaesthesia. STEP 3: SPINAL ANAESTHESIA The rapid onset of spinal anaesthesia reduces operating theatre waiting times. The epidural catheter can be used to maintain anaesthesia as long as desired.