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Two Systems for Continuous Nerve Blocks

You have the Choice: Catheter through the Needle or Catheter over the Needle

By definition, a continuous nerve block is done with the placement of a small flexible tube (catheter) placed next to the nerve. The catheter is then connected to a pump which infuses anaesthetics to keep the area numb for 2-3 days usually.

But what innovative contribution have we made to this technology?

In the 1990s, PAJUNK®, together with Dr G. Meier, developed a new technique for catheter placement.

It is crucial for a continuous nerve block that the system remains sterile. Therefore, we developed an innovative procedure through direct placement of the sterile catheter through the needle. 


Pajunk offers the widest nerve block catheter portfolio in the industry. Our portfolio includes amongst others the echogenic, stimulating and non-echogenic Catheter-Through-Needle systems, including a specialty curled catheter.


"The “catheter through needle technique”, we developed together with Dr. Meier, revolutionized not only the catheter placement in clinical practice, but is also the starting point for further key developments in our house." 

Simone Pajunk-Schelling


2014 New Development – Catheter-Over-Needle System


Developed together with Dr. Ban Tsui, the E-Cath® / E-Cath® Plus combines the best from clinical experience and engineering expertise, resulting in a system that addresses the biggest catheter problems in CNBs: complexity, catheter kinking, anaesthetic leakage and catheter dislocation and migration.1,2,3,4



What advantages a Catheter-Over-Needle System has?

  • Making catheter placement as easy as a single shot
  • Reducing the chance of leakage
  • Reducing the chance of dislocation and catheter migration1
  • Reducing the chance of catheter kinking
  • Offering an optimised local anaesthetic spread
  • Providing optimised ultrasound visiblility of needle tip, needle shaft, and catheter


This revolutionary technique for continuous peripheral nerve blocks – as easy as the Single Shot.



From the interview with Dr. Meredith J. Hall, Anaesthesiologist at Bronson Battle Creek Hospital in Michigan (USA)

There are many doctors who don't do continuous nerve blocks. You, on the other hand, do. Where do you see the advantages?


For example, with femoral blocks for knee replacement surgery. This is a procedure that allows surgical interventions on the leg. We used to use the single-shot technique for this, i.e., a single injection. But when I went on rounds in the morning, I saw patients in absolute agony, sweating, under morphine. This problem simply does not exist with catheters. With the indwelling catheter, 90 per cent of the time patients sit down in the morning for breakfast, talk to each other and, at best, leave the hospital the next day. Instead of only 12 to 18 hours of pain relief with a single-shot injection, patients have three or more days of pain relief – while they are still at the hospital or sometimes at home. You see, the E-Cath ® is used in many ways in our hospital: for hip fractures, broken arms, total hip and total knee replacements and so on. Having this option really helps us a lot.


The E-Catheters are spot on in many ways and hopefully Pajunk will maintain that quality and reliability of products. When I started as an anaesthesiologist, we did not have Pajunk products. We worked with the old epidural pain catheters. These were very cumbersome, unreliable and you could easily pull them out. That is no longer a problem with the E-Cath.


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1 Ip V. H. Y. et al. The catheter-over-needle assembly offers greater stability and less leakage compared to the traditionalcounterpart in continuous interscalene nerve blocks: a randomized, patient-blinded study, Can. J. Anesth. 2013; 60: 1272–1273
2 Ip V. H. Y. et al. The safety of an interscalene catheter-over-needle technique, Anesth. 2013; 68: 774–775
3 Herring A. A. et al. Emergency department placement of perineural catheters for femoral fracture pain management, Am. J. Emerg. Med. 2014; 32(3), 287: 1–3
4 Tsui B. C. H. et al. Less leakage and dislodgement with a catheter-over-needle versus a catheter through-needle approach for peripheral nerve block: an ex vivo study, Can. J. Anesth. 2012; 59: 655–661 (E-Cath is called Multi-Set in this study)

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